Novartis has hit out at Bayer with an analysis that shows its eye drug Lucentis is more cost effective than the German firm’s Eylea for the treatment of diabetic macular oedema (DMO) in the UK

The analysis, undertaken by Novartis and published in the ClinicoEconomics and Outcomes Research, concluded that lifetime costs per patient of treating DMO were £20,019 for Lucentis (ranibizumab) and £25,859 for Eylea (aflibercept) 2mg every 8 weeks after five initial monthly doses.

The net benefit of treating with ranibizumab is £6,768 at a willingness-to-pay threshold of £20,000/QALY.

The two drugs have been close competitors in the market for some time, and this is not the first time the question of their cost effectiveness has arisen.

NICE only recommended Eylea and Lucentis for DMO after agreeing a discount with the manufacturers, while in 2013 German pricing watchdog IQWIG said that it saw no additional benefit from Eylea compared to Lucentis for the treatment of wet age-related macular oedema (AMD).

And both drugs have been facing competition in the wet AMD market from off-label use of Roche’s Avastin (bevacizumab). This could save the NHS more than £100 million a year, according to commissioners.

Despite this, both drugs have been big sellers for their companies, with Eylea being named as one of the key drivers of Bayer's record sales in 2014.