KEY POINTS:
Most people suffering from the country's leading cause of blindness are currently forced to use a drug registered as a colon cancer treatment, the Royal Australian and New Zealand College of Ophthalmologists (RANZCO) says.
The New Zealand branch of RANZCO is calling for government drug-buying agency Pharmac to fund Lucentis which is a drug tailored to the treatment of wet macular degeneration - a condition affecting blood vessels around the retina.
About 15,000 New Zealanders experience symptoms of the condition, most of them aged over 50.
Patients currently have the option of stumping up for Lucentis, at a cost of around $2000 per treatment, although it's availability is limited.
With some patients requiring up to 14 treatments over three years the cost puts it out of reach for many.
Alternatively, and where available, they are able to use Avastin, a drug created for the treatment of colon cancer but which works in the same way as Lucentis and at a cost of around $100 per treatment.
Both treatments involve injecting the drug into the patient's eye.
RANZCO spokeswoman Dianne Sharp said district health boards sometimes funded Lucentis in cases where people did not respond to Avastin.
Pharmac medical director Dr Peter Moodie said Avastin worked out considerably cheaper as less was needed per treatment. DHBs were free to fund whichever drug they chose and it was not Pharmac's decision.
Dr Moodie said Avastin was widely used by ophthalmologists in New Zealand and around the world despite its not being registered as an eye treatment.
Dr Sharp, an Auckland-based ophthalmologist, said while there were on-going trials comparing the two drugs, the results had not yet been released.
"Basically Avastin is approved for treatment of colon cancer and there is no data on it's use for injection into the eye, apart from just general use."
Even if people were happy with the unregistered drug, it was not always available.
"It is being used in some hospitals, some don't have access to it because (the use) is off-label."
Dr Sharp said there had been reports in Australia of Avastin causing inflammation, although that might have been related to a single batch of the drug.
"It may be that at some stage we find that Avastin is as good, we may find that it has a good safety profile, but it hasn't been through any studies."
Dr Sharp said without proper testing to go on Pharmac's attitude was to say "it seems to work, so let's use it".
"The Lucentis drug has been through the trials and there is safety data."
Her own practice offered both drugs as most people could not afford Lucentis.
She said there had been cases where patients had switched to Lucentis and shown "incredible recovery" after not responding to Avastin. Having been designed for the eye, Lucentis has smaller molecules which might penetrate better, she said.
While DHBs are able to fund whichever drug they choose, RANZCO wants Pharmac to take a two-pronged approach - to recommend DHBs fund Lucentis and to provide it's own funding to make the drug available for use in private practices.
"It would be a quite ridiculous (drain) on the facilities of the hospital to say that everybody who needs it would have to go through the hospitals," Dr Sharp said.
Hospital waiting lists could also be an issue as the drug only worked at the early stages of degeneration.
"If patients don't have access to this treatment on an urgent basis then they will lose vision."
RANZCO has written to Pharmac asking for formal consultations.
- NZPA
