Cost regulators have now published final guidance endorsing routine NHS use of Bayer's Eylea for all patients with visual impairment due to branch retinal vein occlusion (BRVO), having initially recommended its use only in the second-line setting.

The National Institute for Health and Care Excellence concluded that Eylea (aflibercept) is more cost effective than current first-line treatment laser photocoagulation for untreated visual impairment caused by macular oedema secondary to BRVO.

The Institute also determined that the injection is more clinically effective when given before, as opposed to after, laser photocoagulation, giving patients access to the therapy at the earliest opportunity.

The decision means that over 13,000 patients will have first-line access to an anti-VEGF treatment proven to achieve superior improvements in vision than existing therapy, in line with Royal College of Ophthalmologists guidelines, Bayer notes.

"This will allow patients to achieve the best possible clinical outcomes upon diagnosis and the opportunity to achieve the positive visual outcomes that we see in real-life clinical practice across other retinal conditions," said Professor Sobha Sivaprasad, consultant ophthalmologist, Moorfields Eye Hospital, London.

"Sight loss can have a devastating impact on an individual and their family so we are pleased that NICE has recognised that patients should have access to an anti-VEGF treatment as soon as possible and in line with guidelines from the Royal College," added Cathy Yelf, chief executive, Macular Society.

BRVO is caused by a blood clot in one of the branches of the main vein in the retina, increasing the pressure in the small blood vessels at the back of the eye, which can lead to blood and fluid leaking beneath the macula (macular oedema). If not treated effectively, macular oedema secondary to BRVO can significantly impact a person's vision.

Eylea (aflibercept) is an anti-VEGF treatment designed to block the growth of new blood vessels and decrease vascular permeability to rapidly deliver sustainable improvements in vision, while offering patients and healthcare professionals a predictable dosing programme.

The drug is licensed in the UK for the treatment of wet age-related macular degeneration, visual impairment due to macular oedema secondary to central retinal vein occlusion (CRVO) and BRVO, visual impairment due to diabetic macular oedema (DMO) and myopic choroidal neovascularisation (mCNV); funding is now mandated for all eligible patients across all licensed indications, except for mCNV.