NICE has published new draft guidance recommending Novartis’ Jetrea for some patients with a rare eye condition.
Specifically, the Institute has recommended Jetrea (ocriplasmin) as an option for treating vitreomacular traction in adults, when associated with a macular holei with a diameter of 400 micrometres or less, only if they have severe symptoms and an epiretinal membraneii is not present.
It is currently the only available medication for the condition, with surgery currently being the only other option.
Vitreomacular traction occurs when the vitreous, a gel-like substance in the eye, pulls abnormally on the retina. This pulling of the gel disturbs the retina, causing swelling and distorted vision, and sometimes a hole in the macular area. It can occur as a result of ageing.
The drug will cost £2,500 per injection and as repeat injections are not recommended, this is the cost for a full course of treatment.
NICE’s expert committee said that the cost per QALY gained would be greater than £21,000, with the upper limit of NICE’s remit usually at £30,000 per QALY gained.
The committee says that Jetrea is therefore a “cost effective use of NHS resources” for treating vitreomacular traction in people with vitreomacular traction with no epiretinal membrane.
Professor Carole Longson, health technology evaluation centre director at NICE, said: “Vitreomacular traction can lead to significant sight problems and even loss of vision in the long run. Although vitrectomy surgery is usually effective in resolving vitreomacular traction, a patient expert described recovery as a very unpleasant process. Surgery also has risks and could damage the eye.
“Ocriplasmin injection represents an innovation in treating patients with vitreomacular traction and, as it provides an alternative to ‘watch and wait’ and/or surgery, would be welcomed by clinicians and patients. NICE is, therefore, pleased to recommend ocriplasmin for this condition in draft guidance.”
Jetrea is a truncated form of human plasmin, manufactured using recombinant DNA technology, and is injected into a patient’s eye. There is no data on how many patients it can treat in the UK, but around 500,000 people in the US and major European markets are estimated to benefit from Jetrea.
It was originally developed by Belgium-based ThromboGenics but in 2012, Novartis bought European rights to the drug in a deal worth as much as 375 million euros.
ThromboGenics retains the full marketing rights for the drug in the US, where it was approved late last year, and is on track to make around $50 million in peak annual sales in the country.
Final NICE guidance is expected to be published in October 2013 and will apply to the NHS in England Wales. The Scottish Medicines Consortium has not yet published its assessment of the drug.
