Current issues and opportunities - Age-related Macular Degeneration

About 10% of patients with AMD have the neovascular (“wet”) form of the condition which, untreated, often results in a rapid decline in visual acuity. Treatment consists of injections of an antibody to Vascular Endothelial Growth Factor (VEGF) into the vitreous cavity of the eye, usually at monthly intervals until the condition stabilises. There has been much debate about the high cost of ranibizumab, the drug approved by NICE for the treatment of neovascular AMD and whether bevacizumab, a less expensive drug which is not licensed for this use can be regarded as equivalent. 

A recent College statement on this subject summarises the current position. It is also important to note that the costs of administration of appointments, diagnosis, monitoring and delivering the injections form a significant proportion of the total cost of the service. Many units have developed very efficient, high-throughput services where imaging, assessment of images by senior ophthalmologists and delivery of the injection (where required) are carried out at the same appointment.   Nevertheless, most areas of the country report difficulties in keeping pace with demand because many patients require multiple injections.

The College has released a statement on intra-ocular injections by non-medical healthcare professionals in response to the pressure that eye departments are under to deliver this treatment to thousands of new and follow-up patients.