Another ‘post-code lottery’ in the UK is expected in the wake of this week’s launch of Pfizer's Macugen for a common cause of blindness, say patient advocates.

According to Steve Winyard, head of public policy at the Royal National Institute for the Blind, UK primary health care trusts (PCTs) are already blocking treatment with Macugen (pegaptanib sodium), a new treatment for age-related macular degeneration which is approved by regulatory authorities in the US, Europe, Canada, Brazil, Argentina, Peru, Pakistan, Philippines and Switzerland.

“UK patients have only been able to get private treatment. In a handful of cases, a consultant has prescribed [Macugen] treatment on a named-patient basis. PCTs are turning people down and say that they will continue to do this until the treatment has been through a NICE [National Institute for Health and Clinical Excellence] appraisal.”

“However the legal position, which has been made very clear [to PCTs], is that they can pay for this treatment – but instead they choose to hide behind the lack of a NICE appraisal. The RNIB and other groups will be pressing hard for this treatment to be made available, even before it has gone to NICE,” he said.

“The drug has been through EMEA, it has been licensed and we are saying that people should not lose their sight, simply because they cannot find the money to pay for it – whether you keep your sight, should not depend on the size of your purse.”

Dr Alan Cruess, professor and head of department of Ophthalmology and Visual Sciences, Dalhousie University, Canada, said Macugen and other drugs in the class of selective VEGF (vascular endothelial growth factor) inhibitors answer a real medical need because they cover the spectrum of wet AMD whereas previous treatments such as photodynamic therapy (PDT) only covered sub-sets of these patients.

Dr Cruess and Mr Winyard were speaking at AMD Action Summit, a meeting of more than 100 ophthalmologists, AMD advocacy groups and government health officials from 21 countries held in Brussels this week (May 14-15th).

At the end of May, EU Ministers will be lobbied to include ‘Smoking Causes Blindness’ warnings on cigarette packets. “Up to one in four cases of blindness could be prevented by smoking cessation,” said Dr Cruess.