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Campaigners have attacked the decision by NICE (the National Institute for Health and Clinical Excellence) to place strict curbs on the use of Lucentis and a total block on the use of Macugen to treat wet age-related macular degeneration (AMD) in England and Wales.

The ruling came only days after the Scottish Executive gave the go-ahead for both drugs to be available on the NHS (Optician, June 15).

In its preliminary ruling, NICE stipulated that Lucentis should be used for people with predominantly 'classic subfoveal choroidal neovascularisation' wet AMD and only when both eyes are affected. It advises the eye with best vision receive the drug. The guidance recommended the use of Lucentis for about 20 per cent of patients with wet AMD.

Commenting on the publication of the guidance, Andrew Dillon, chief executive of NICE, said: 'When treatments are very expensive, we have to use them where they give most benefit to patients. Most people with AMD only seek help once the disease is beginning to affect their second eye. our independent advisory committee believes the right thing to do is to treat and try to save as much sight as possible in the better-seeing eye.'

The decision was attacked by Tom Bremridge, chief executive of the Macular Disease Society, who said that efforts were already under way to appeal. 'We are appalled by the NICE consultation document - limiting the treatment options to 20 per cent of patients who would benefit is unjustifiable and allowing one eye to go blind before treating the second eye is cruel and totally unacceptable.'

Responding to the NICE recommendations to withdraw the use of Macugen, Dr James Goodwin, head of research for Help the Aged, said: 'This is one of the most despicable and shameful recommendations made by NICE to date. To deny patients quality of life by taking away sight-saving drugs on the basis of cost is at best crude and at worst discriminatory.'

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