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NICE rebuffs Lucentis in macular edema

November 24, 2011 12:35 AM UTC

The U.K.'s NICE issued draft guidance recommending against Lucentis ranibizumab from Novartis AG (NYSE:NVS; SIX:NOVN) to treat macular edema secondary to central retinal vein occlusion (CRVO) or branch retinal vein occlusion (BRVO). According to the committee, there were "gaps and uncertainties" in the evidence for the drug's effectiveness compared to other treatments used in the U.K. NICE concluded that Lucentis would not be cost-effective, even with a patient access scheme under which Novartis would provide Lucentis at an undisclosed discount.

NICE said the incremental cost-effectiveness ratio (ICER) per quality-adjusted life year (QALY) for Lucentis in CRVO is L43,800 ($68,779) vs. best supportive care and L37,400 ($58,729) vs. Ozurdex dexamethasone intravitreal implant from Allergan Inc. (NYSE:AGN). In July, NICE published final guidance backing use of Ozurdex to treat macular edema following CRVO. Ozurdex is also recommended following BRVO when laser photocoagulation, the standard of care, is not beneficial or suitable. In BRVO, the committee said the ICER for Lucentis compared to laser photocoagulation is significantly higher than the company's base-case of L20,500 ($32,191) per QALY gained. NICE usually considers products with ICERs less than or equal to L30,000 per QALY to be cost-effective. Comments are due Dec. 15 (see BioCentury Extra, June 6). ...