Iluvien gets NHS nod
NICE is gearing up to allow Alimera Sciences’ implant Iluvien to be used on the NHS as an option to treat a common diabetes-related eye problem which leads to blurred or double vision.
In final draft guidance issued today, NICE has recommended Iluvien (fluocinolone acetonide intravitreal implant) to treat some patients with chronic diabetic macular oedema (DMO).
The implant, which has a list price of £6,600 but will be available at a discount under a patient access scheme, releases 0.2 micrograms of fluocinolone acetonide per day for up to 36 months.
Another may be put in after a year if the condition worsens or there is an increase in retinal thickness but only one eye can be treated at any one time.
It should be used, NICE says, if the condition does not respond to other therapies such as laser treatment and if the person has had their natural lens surgically replaced with an artificial intraocular lens - a sub-group of patients in which Iluvien has been shown to be clinically effective.
Around 14% (336,000) of people in the UK with diabetes have DMO and its prevalence goes up to 29% (696,000) for those who have used insulin for more than 20 years.
Iluvien is a corticosteroid with anti-inflammatory and anti-vascular endothelial growth factor (VEGF) properties, decreasing the build-up of excess fluid (oedema) which can lead to severe visual impairment.
A reduction in connective tissues around capillaries in diabetes sufferers and an increased amount of the VEGF protein cause the blood retinal barrier to leak but Iluvien can help improve vision.
Other treatments apart from laser therapy are available: in January, NICE gave the green light to Novartis’ Lucentis to treat DMO, after ruling in November 2011 that its cost and clinical effectiveness did not merit use on the NHS.
Novartis revised its patient access scheme, thus lowering the drug’s price to the NHS, and presented updated analyses showing Lucentis to produce a superior relative effect among a sub-group of people with DMO.