The National Institute for Health and Care Excellence has published final draft guidance backing the use of Santen’s eye drug Ikervis on the National Health Service in England and Wales, after an initial rejection earlier this year.

The Institute is now endorsing Ikervis (ciclosporin) to treat severe keratitis in adults with dry eye disease which has not improved despite treatment with artificial tears.

Keratitis is an inflammation of the cornea caused by reduced tear production or excessive tear evaporation, characterised by symptoms such as irritation and redness in the eyes, blurred vision, and a sensation of grittiness or a foreign body in the eye. If left untreated, it can result in blindness in severe cases.

Ikervis blocks the expression of pro-inflammatory cytokines in the cornea and tear gland, helping to increase the eyes' natural ability to produce tears while reducing inflammation. 

The acquisition cost of a monthly course of Ikervis is £72 (excluding VAT), but costs may vary in different settings because of negotiated procurement discounts.

Earlier this year, NICE said evidence submitted for the drug was too uncertain, but Santen subsequently responded to its call for more information to help convince the Institute of its cost-effectiveness. The medicine has been also accepted for use by the Scottish Medicines Consortium.