Re: A licence to cure - four questions every CCG should ask of their Ophthalmology dept
After substantial effort by many people, over a long period of time ; the completion of two substantial RCTs and much lobbying it is a fact that patients are still nearing the opportunity cost of lucentis and eylea being the drug of choice in AMD and other conditions.
This opportunity cost manifests itself as poorer quality of care, less care and no care. Those that bear the opportunity cost are anonymous, and may have any condition, in this respect the investment in aVEGF are depriving patients with cardiovascular or musculoskeletal disease of the best possible care.
One must question whether the unfairness and inequity this causes is acceptable.
The evidence is clear. Lucentis and avastin are equally efficacious and safe in AMD and probably DMO . In the minds of many all the available agents are equally effective, there is growing evidence of this. There is good evidence of equivalent safety .
Maintaining the current status quo is unfair and inequitable. It seems unlikely that any national agency will resolve this anytime soon. There are four burning questions that each CCG should ask of their Ophthalmology dept
1. Give the Cochrane review, do you really think the "it's not safe" argument is credible
2. What do you prescribe to private patients
3. Send us your justification for denying others treatment if you still use lucentis or eylea as a first line agent.
4. in the spirit of openness and complete transparency, please be open about how much funding your hospital, department and individual clinicians have received from companies with a stake in this market; in cash or in kind.
It seems unfair to expect patients with other diseases (so say, less investment in MSK, Gastro or dermatology) to foot the bill (for ever growing ophthalmology drug bill) by way of less good care, less investment and maybe service cuts.
It's unfair and inequitable to expect patients with cataract or glaucoma to foot the bill for ever increasing growth in aVEGF areas also. Continuation of this is inequitable and unfair. It's also inefficient and leads to net social loss.
Nobody disputes that lucentis is effective. Its just there is a cheaper and equally effective alternative.
Competing interests:
I have participated in an Advisory Board for Bayer HealthCare for which my employer was reimbursed for my time.
Rapid Response:
Re: A licence to cure - four questions every CCG should ask of their Ophthalmology dept
After substantial effort by many people, over a long period of time ; the completion of two substantial RCTs and much lobbying it is a fact that patients are still nearing the opportunity cost of lucentis and eylea being the drug of choice in AMD and other conditions.
This opportunity cost manifests itself as poorer quality of care, less care and no care. Those that bear the opportunity cost are anonymous, and may have any condition, in this respect the investment in aVEGF are depriving patients with cardiovascular or musculoskeletal disease of the best possible care.
One must question whether the unfairness and inequity this causes is acceptable.
The evidence is clear. Lucentis and avastin are equally efficacious and safe in AMD and probably DMO . In the minds of many all the available agents are equally effective, there is growing evidence of this. There is good evidence of equivalent safety .
Maintaining the current status quo is unfair and inequitable. It seems unlikely that any national agency will resolve this anytime soon. There are four burning questions that each CCG should ask of their Ophthalmology dept
1. Give the Cochrane review, do you really think the "it's not safe" argument is credible
2. What do you prescribe to private patients
3. Send us your justification for denying others treatment if you still use lucentis or eylea as a first line agent.
4. in the spirit of openness and complete transparency, please be open about how much funding your hospital, department and individual clinicians have received from companies with a stake in this market; in cash or in kind.
It seems unfair to expect patients with other diseases (so say, less investment in MSK, Gastro or dermatology) to foot the bill (for ever growing ophthalmology drug bill) by way of less good care, less investment and maybe service cuts.
It's unfair and inequitable to expect patients with cataract or glaucoma to foot the bill for ever increasing growth in aVEGF areas also. Continuation of this is inequitable and unfair. It's also inefficient and leads to net social loss.
Nobody disputes that lucentis is effective. Its just there is a cheaper and equally effective alternative.
Competing interests: I have participated in an Advisory Board for Bayer HealthCare for which my employer was reimbursed for my time.