The drug company Novartis is taking a primary care trust cluster on the south coast of England to court over its decision to give NHS ophthalmologists the option to use the cheaper bevacizumab (marketed as Avastin) for wet age related macular degeneration (AMD) rather than the considerably more expensive ranibizumab (Lucentis).

Bevacizumab and ranibizumab are derived from the same antibody and work by blocking vascular endothelial growth factor. In the United Kingdom they are both marketed by Novartis. Ranibizumab costs £890 (€1090; $1440) a dose, is licensed for injection into the eye specifically to treat macular degeneration, and has been recommended by the National Institute for Health and Clinical Excellence (NICE) for the treatment of wet AMD. Avastin is licensed for treating cancer and costs between £50 and £100 a dose.

In September last year the board of the Southampton, Hampshire, Isle of Wight, and Portsmouth primary care trust (PCT) cluster agreed to fund bevacizumab to treat wet AMD by NHS ophthalmologists to save money. The cluster estimated that a switch could save £5m a year. Novartis has asked …