NHSCC responds to outcome of judicial review on Avastin usage

Today’s judgement provides welcome clarity on what has been a long-standing issue for commissioners.

julie-wood_websiteResponding to today’s ruling, Julie Wood, chief executive of NHS Clinical Commissioners said:

“We are delighted by today’s ruling that clearly shows the northern CCGs acted lawfully in introducing the preferred treatment option for Avastin. CCGs across the country have been thwarted in their various attempts to introduce the cheaper but equally effective drug Avastin for the treatment of wet AMD and the court rightly makes several findings about the legality of both CCGs and clinicians to determine whether Avastin is clinically effective and safe for ophthalmic use in local areas.

“This has been a culmination of considerable hard work by colleagues locally, supported by NHSCC at a national level since 2015. We are really pleased that the northern CCGs remained true to their belief that this was the right thing to do for their patients and populations in spending the NHS pound to best effect, and that it was lawful to do so.

“The potential cost savings from switching to the cheaper Avastin, with no impact on patient outcomes, are huge, and when resources in the NHS are so stretched we must ensure that maximum value is delivered for every NHS pound.

“We now call on the Department of Health and Social Care and NHS England to take all steps in acting on this judgement and actively support the implementation of similar pathways across the country for the benefit of patients, public and taxpayers.”

NHS Clinical Commissioners, the independent membership body for clinical commissioning groups, has been active in this area for some time, and first highlighted the issue in February 2015. Earlier this year, following the release of the NICE guidance we worked with the GMC to clarify their position regarding the use of off-label medicines and fitness to practice processes.

The judgement highlights the importance of local medicines optimisation teams within CCGs, who work hard to ensure the best value for patients, the public and taxpayers.

Avastin is not currently licensed for the treatment of Wet AMD, but guidance released by the National Institute for Health and Care Excellence (NICE) in January 2018 concluded that there are “…no clinically significant differences in effectiveness and safety…” between Avastin and the current market authorised medicines, ranibizumab (Lucentis) and aflibercept (Eylea) for the treatment of this condition. Furthermore, Avastin is the most cost-effective treatment compared to the others available, with the potential to release millions of pounds of vital funding locally which can be reinvested in other frontline NHS services.

21 September 2018