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Lucentis

The right hon. Member for Maidstone and The Weald (Miss Widdecombe) deserves credit for securing the debate. Her concern about such issues is well known. If she will bear with me, I will make some remarks about aspects of the working of NICE and the NHS in general, before addressing her specific points. I am pleased to pay tribute to all NHS staff. The right hon. Lady has expressed her concerns passionately tonight, but I am confident that she would also wish to congratulate staff in the main on their work, especially those in the West Kent PCT area and in Maidstone and the Weald. All of us would be greatly concerned were there any risk to our sight or to that of our loved ones. My mother had dry macular degeneration, for which no treatment was available, and I watched her sight and quality of life deteriorate. There are approximately 26,000 new cases of wet age-related macular degeneration every year, and it is the most common cause of sight loss in people aged over 60. We can only try to imagine the worry of someone who is at risk of losing their sight. We all want access to the best treatments available. Understandably, there is a lot of interest in this area, especially as the development of new treatments potentially offers hope to more patients than in the past. Many are helped and treated successfully. To provide the best possible services for NHS patients, we have a duty to ensure that new treatments used in the NHS are both clinically sound and cost-effective. That is why NICE was established in 1999. I need to remind the House of the purpose of NICE and the importance of its role, as it has had great achievements and helped many people. NICE was established as part of a range of measures to tackle the variations in prescribing practice across the country. Before NICE, guidance was issued by numerous bodies at national, regional and local levels, which was confusing not only for patients but, most importantly, for clinicians. The lack of coherent guidance was in part responsible for the variation in prescribing practice across the country. I am sure that the right hon. Lady is aware that NICE issues robust, evidence-based guidance on the clinical and cost-effectiveness of new and existing treatments. It has already recommended the use of photodynamic therapy for treating wet age-related macular degeneration in some patients. All PCTs are required to fund such treatment in accordance with that guidance. I am sure that the right hon. Lady knows that NICE is currently appraising Lucentis and Macugen for the treatment of age-related macular degeneration, and that draft guidance for the NHS was published earlier this year. That guidance recommended Lucentis, subject to a number of clinical criteria, but not Macugen. However, my Department has made clear in good practice guidance for the NHS, published in December 2006, that funding for individual treatments should not be withheld simply because NICE has not issued final guidance.