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Pharma giants sue NHS for trying to save money
SAM TOBIN reports from the High Court

TWO pharmaceutical giants have dragged the NHS to the High Court to prevent patients being given a cheaper sight-saving drug which could save millions.

Twelve clinical commissioning groups (CCGs) in north-east England want to treat wet age-related macular degeneration (AMD) — the leading cause of vision loss  — with an anti-cancer drug found to be “as clinically effective and safe,” as well as being significantly cheaper.

They say using Avastin could save the region’s NHS nearly £50 million over five years, while the BMJ has reported estimates that a national switch to Avastin could save the NHS £500m a year.

But Novartis and Bayer — which market rival, licensed drugs Lucentis and Eylea — claim the CCGs cannot use Avastin as it is not licensed for the treatment of wet AMD.

Tom de la Mare QC, for Novartis, said: “This is a systematic attempt on the part of the 12 defendants … to devise a way to use … an unlicensed drug for the treatment of a very common condition.”

He conceded that his client’s alternative was “considerably more expensive” and was “on any view equivalently efficacious,” but said that using “unlicensed medicines in places of licensed medicines is quite inappropriate.”

He claimed that the policy was “driven by cost alone” and stated that to “seek to reduce or avoid the costs of licensed medicines” by using an unlicensed alternative was unlawful.

Mr de la Mare pointed out that NHS England had last week announced a “procurement process” for the supply of Lucentis and Eylea, which he described as an attempt to “play one licensed manufacturer off another” to lower prices, but added that was a “lawful tool” to do so.

He also admitted that there was a “considerable weight of practitioners who think it [Avantis] is safe in principle … even though it has not been through the rigorous licensing process.”

The CCGs say to allow the claim would mean “thousands of other NHS patients will be denied clinically effective medical treatment because resources will be used purchasing licensed drugs [instead of] a much cheaper and equally safe” alternative.

They also say that Avantis is used in Austria, France, Ireland and Italy — where Novartis has lost a series of court cases about the use of the drug.

The hearing continues.

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