There has been much discussion over the subject of AMD treatments the table below lays out the costs to the NHS for drugs in hospitals in 2012. The cost of Lucentis at that time was £193 million. Since then drug prescribing for AMD has changed Eyelea is now probably the top drug.

Table 2. Top 10 medicines by cost for medicines positively appraised by NICE issued

in hospital in 2012

DRUG NAME NHS Cost £ (thousands)
Adalimumab (Humira,AbbVie)


Etanercept (Enbrel, Pfizer)


Ranibizumab (Lucentis, Novartis)


Rituximab (MabThera, Roche)


Infliximab (Remicade, MSD)


The interesting wording on the table is ‘positively appraised by NICE’ . There was much discussion about the drug Avastin a very similar drug to Lucentis it had been developed for a very different probem. It first gained approval in the US to fight colon cancer, but was subsequently discovered to be effective against AMD.

The interesting thing about it was that its cost was  roughly 15x cheaper than Lucentis. The NHS could have saved £180 million pounds by switching from just one drug to another. Why didn’t they do this? Well the simple answer was that Avastin was not NICE approved so clinicians were unable to use it. Why didn’t NICE approve it? NICE can only approve drugs that are submitted to it, if they are not submitted they are not used.

Avastin is a drug developed by Roche, Lucentis was developed by Novartis, who have a holding in Roche. Roche for some reason never felt the need to submit Avastin to NICE maybe they didn’t want to sell their drug to the NHS, I can’t for the life of me think why?…

The idiocy of NICE is stunning it is the National Institute for health and Care Excellence, common sense doesn’t seem to come in to it. Let us hope Novartis spent their £180 million pounds on lots of research into AMD.