New NICE rules.

Listened to an extended interview with Andrew Dillon, Chief Executive on the National Institute of Clinical Excellence on the radio as driving home from Cardiff today. It was refreshingly honest, and very interesting. A big part of the discussion concerned this decision by NICE which was to change its recommendation on the treatment of wet Age-related Macular Degeneration (AMD). Previously NICE had recommended that this new effective treatment, Lucentis, which costs about £10,000 per eye, should only be available on the NHS if the patient has already lost sight in one eye. Recently, NICE decided that the treatment should be prescribed for the first eye as well. Mr Dillon apologised, genuinely and profusely to all those who have lost their sight while NICE spent too long coming to its decision. I should add that this situation applies to England only. The position is different in Wales and Scotland.

The aspect of the issue that particularly interests me is the role played by the the manufactures of Lucentis, Novartis. The reason that NICE has been able to change its recommendation is that Novartis has agreed to pick up part of the cost, thus making Lucentis sufficiently cost-effective to meet the NICE criteria. Novartis has agreed to supply free any injections needed after the first 10, if they prove to be necessary. This seems to me to be a fundamental change in NHS policy. This is providing NHS treatment to patients where the private sector is paying for part of the treatment. The decision on AMD is wonderful news to sufferers from AMD, but it could also be important news for others who want to supplement drugs available within the NHS by treatments supplied by the private sector. Personally, I thought that movement in this direction is inevitable.