Patients benefit from early use of sight-saving drug

1:03pm Thursday 4th September 2008

MORE than 60 people have had their sight saved because of swift action by Herefordshire health professionals.

They decided not to wait for the National Institute for Clinical Excellence (NICE) to approve the sight-saving drug Lucentis – and gave the go-ahead for its use at Hereford County Hospital in December.

Since then the patients, all over the age of 50, have been receiving the treatment for wet age-related macular degeneration, which generally leads to blindness.

Wet age-related macular degeneration is a disease associated with ageing that gradually destroys sharp, central vision, needed for seeing objects clearly and for common daily tasks such as reading and driving.

It affects the macula, the part of the eye that allows people to see fine detail.

The treatment is carried out at the county hospital’s Victoria Eye unit with injections into the eye under local anaesthetic.

Patients usually have eight injections in the first year with up to six in the second year, at a cost to the NHS of around £17,000 for the course.

Consultant ophthalmologist Alaric Smith said patients had their eyesight stabilised and, in the majority of cases, improved, with at least 70% better and more than 30% significantly better.

“We have some very delighted patients who have benefited from this decision, taken locally,” said Mr Smith.

But he agreed there had been disappointed people too, for whom the sight-saving treatment had come too late, with the disease too advanced.

Previously, a limited number of patients with the condition were sent to a centre in Birmingham for photo dynamic therapy, but the use of Lucentis was deemed far superior.

With NICE taking its time in giving approval for its use, Mr Smith and his team at Hereford County Hospital, supported by patients fearful of going blind, lobbied Herefordshire Primary Care Trust not to wait and to foot the NHS bill for the drug.

The PCT agreed and the first patients, who had to be vetted by a PCT health panel, started their Lucentis treatment last December.

In January, the PCT agreed that Mr Smith and his team at the County Hospital, following correct protocol, should judge themselves who would benefit from the treatment. This year, the hospital has treated 58 Herefordshire patients and another 14 from outside the county with their own health authority footing the bill.

Previously, NICE had stipulated that patients could only receive treatment for one eye when the other was totally blind, but has now reversed its decision.

Last week, it approved the use of Lucentis and gave health authorities three months to set up the mechanism to use it.

But with Herefordshire PCT ahead of the game, Mr Smith said procedures were already progressing smoothlyand it was expected that an average of 60 people would need it each year.

With the national publicity given to the drug, he expected an initial rush of patients seeking advice and warned there could be disappointment for some.

If the disease was too advanced, with serious scarring of the eyes, the treatment would not be appropriate.

PCT chairman Joanna Newton said the decision to give the go-ahead last year for Lucentis treatment to help prevent people going blind was the right one to make.

The implications of blindness and the quality of life far outweighed the cost to the NHS, she said.