The North East Treatment Advisory Group (NETAG) has produced an updated appraisal of bevacizumab for the management of neovascular age-related macular degeneration and recommended bevacizumab 1.25 mg intravitreal injection as cost effective treatment option for this condition. The group was satisfied that the relative clinical efficacy and safety of bevacizumab for AMD had been adequately demonstrated.

It should be noted that bevacizumab is not licensed for any ophthalmic indication. Ranibizumab is licensed for wet age-related macular degeneration and there is NICE guidance available which supports ranibizumab in this indication.

The Group was concerned about the implications of using an unlicensed treatment where a licensed alternative treatment is currently used, and was mindful of concerns raised by clinicians regarding prescribing responsibilities and patient information. However, it was felt that these issues were not impossible to address and could be dealt with by service commissioners. The appraisal document states that issues regarding liability associated with prescribing an unlicensed treatment may need to be resolved. These issues extend to possibly obtaining patient consent and providing information for patients. The Group noted the substantial cost-savings that could be obtained from using bevacizumab instead of ranibizumab in AMD, even with an assumption of a reduced cost of ranibizumab.

Please refer to documentation linked below for further details.