Following a speedy appraisal Bayer's Eylea has been recommended by cost regulators for use on the NHS to treat wet age-related macular degeneration.

In final guidance, the National Institute for Health and Care Excellence has ruled that the drug, which will now compete with Novartis' Lucentis (ranibizumab) in the NHS landscape, should be an option for patients with the condition.

As is often the case, the actual price the NHS will be paying for the drug remains shrouded in secrecy, so making comparisons between Eylea (aflibercept) and Lucentis - the only other NICE approved drug in this setting - is difficult.

Earlier this year, Novartis was forced to drop the price of its drug - though it has not disclosed by how much - in an attempt to stem the growing tide of healthcare professionals favouring "off-label" use of Roche's much, much cheaper cancer drug Avastin (which has no license for wet AMD) over Lucentis.

The cost of a 4mg vial of Eylea is £816 (providing a single 2mg dose), and so on paper a little more expensive than Lucentis, which was roughly £760 a shot pre discount. However, the cost of treatment is dependent on the number of injections needed, so overall it could end up being a cheaper option.

Regarding its real world price, a spokesperson for Bayer would only say that the company "is offering an Eylea Access Scheme if a signed confidentiality agreement is in place", but also stressed to PharmaTimes that details of these arrangements "are commercially in confidence and we cannot comment publicly.”

Abilify and Revolade also in

Meanwhile, NICE has also issued final guidance recommending Otsuka's Abilify (aripiprazole) as an option for treating moderate to severe manic episodes in teenagers with bipolar I disorder.

Its appraisal committee concluded that, based on the evidence available, the drug was as effective - both on clinical and cost parameters - as other antipsychotics for treating acute mania, and also has a comparable adverse events profile.

Completing a trio of final guidances, the Institute has also endorsed the use of GlaxoSmithKline's Revolade (eltrombopag) as an option for some adults with the bleeding disorder chronic immune (idiopathic) thrombocytopenic purpura (ITP).

'Routine' use of the drug on the NHS will now be funded in ITP patients who have had their spleens removed and are unresponsive to other therapies, as well as as a second-line treatment in those who have not been able to have the procedure.  

The recommendation is also contingent on the continued provision of a patient access scheme, the details of which have not been revealed.

Lamenting the "lengthy" three and a half year process to NICE's approval of the drug, Erik Van Snippenberg, General Manager, GlaxoSmithKline (GSK) UK, said he is pleased with the decision. "With eltrombopag we hope to ultimately make a meaningful difference in the quality of life of cITP patients and contribute to potential savings for the NHS,” he noted.