As a blindness charity is accused of helping pharmacy giant block cheap drug that could help thousands we ask... should health charities stop taking cash from drug firms?
.Why is the RNIB campaigning against a drug that prevents sight loss?
.The RNIB receive funding from the drug company's more expensive rival
.The row has thrown a spotlight on the truth about charities and drug firms
.Health charities risk their reputations by accepting money from companys
Suppose there were a wonder drug that could not only prevent thousands of elderly people losing their sight, but also save the NHS £100 million every year? In fact, such a drug exists: Avastin.
So why is the Royal National Institute of Blind People (RNIB), one of Britain’s biggest sight charities, actively campaigning against its use?
And does that opposition have anything to do with the RNIB receiving funding from the drug company behind Avastin’s more expensive rival?
The charity says it has safety concerns about Avastin. Yet experts campaigning to see this cheaper drug used on the NHS say it’s perfectly safe and as effective as the standard treatment.
Whoever is right, the row has thrown a spotlight on an uncomfortable truth: that some of Britain’s best-known health charities are risking their reputations as independent patient champions by accepting hundreds of thousands of pounds from the pharmaceutical industry.
This investigation has discovered that, in the past year alone, drug companies gave more than £8 million to more than 200 UK patient charities, some of which have lobbied the NHS to use drugs or equipment produced by their benefactors.
It’s a relationship that raises serious questions. Rather than lobbying the NHS to use certain drugs produced by the firms that fund them, shouldn’t charities be, for example, pressuring the drug companies to reduce their prices?
Some charities are so concerned about the effect of such relationships on their independence that they won’t take funding from drug firms.
The row over Avastin centres on a condition called wet age-related macular degeneration (wet AMD), which causes gradual loss of central vision. It can be halted with drugs that stop the growth of blood vessels causing the problem. The approved treatment is Lucentis, developed by a subsidiary of pharmaceutical giant Roche.
Avastin (which is also owned by Roche, but was developed for cancer) works in the same way as Lucentis for wet AMD. It has been shown to be as safe and as effective as Lucentis in treating it. Crucially for the NHS, Avastin is far cheaper: if it were used instead the NHS could save £100 million a year. It’s already widely used by private patients in the UK and other parts of the world.
Yet the National Institute for Health and Care Excellence (NICE) will only approve drugs for the use they’ve been tested for — and when approval has been requested by the drugs firm. Both Roche and Novartis — which has the licence to sell Lucentis in more than 100 countries — have resisted calls for trials so Avastin can be licensed for the eye condition, according to a report in the British Medical Journal in April.
The report also alleged that researchers who carried out independent trials had faced ‘threats and intimidation’, and it criticised the RNIB for apparently siding with Novartis.
The RNIB said it has ‘been campaigning hard’ to stop health authorities switching to Avastin. In March, it said it was ‘delighted [its] pressure had paid off’, with commissioning groups backing down from this ‘risky, cost-cutting exercise’.
An RNIB spokesperson told us it was ‘not anti-Avastin, [but] pro-patient safety’, insisting using Avastin without a licence puts patients’ safety at risk as ‘there is currently no national guidance on how it should be prepared for use in the eye, the dosing . . . and how it should be stored’.
But is Avastin risky? An authoritative analysis by the Cochrane Collaboration, an organisation regarded as providing the highest standard in evidence-based medicine, concluded there was no difference in safety between Avastin and Lucentis — and that health policies preventing the use of Avastin on safety grounds were ‘not sustained by evidence’.
Last year, Novartis gave the RNIB £166,000. This wasn’t the charity’s largest contribution from a drug firm: Bayer, which makes treatments for eye conditions, too, donated £266,000. But the relationship between the RNIB and Novartis is especially close, as the head of external affairs and acting head of market access at Novartis UK is Barbara McLaughlan, who, until 2011, was the RNIB’s policy and campaigns manager.
Novartis told Good Health: ‘[We are] committed to supporting the important work of patient groups and working collaboratively on specific projects where there is a shared interest and benefit to patients. We strive to build relationships based on mutual respect and transparency.’
Meanwhile, the RNIB flatly denies its position on Avastin or any other issue is influenced by pharmaceutical funding, which, it says, accounts for no more than 0.5 per cent of its income.
Read more here: http://www.dailymail.co.uk/
Oh what a tangled web can be woven when Health charities risk their reputations by accepting money from companies. But what else are they to do. Is it right that these charities have to rely heavily on public and company funding? It is up to each Charitable Body to deal honestly and openly with money and research but with all that goes on is this really likely to happen?
Oh my. Note that Avastin is now accepted by Medicare in the USA.
Although the efficacy of ranibizumab is well-supported by extensive clinical trials, the cost effectiveness of the drug is questioned. Since the drug merely stabilizes patient conditions, ranibizumab must be administered monthly. At a cost of $2,000.00 per injection, the cost to treat wet AMD patients in the United States is greater than $10.00 billion per year. Due to high cost, many ophthalmologists have turned to bevacizumab as the alternative intravitreal agent in the treatment of wet AMD. The drug costs $15.00 to 50.00 in the United States.
In 2007, Raftery, et al. reported in the British Journal of Ophthalmology that, unless ranibizumab is 2.5 times more effective the bevacizumab, ranibizumab is not cost-effective. It was concluded that the price of ranibizumab would have to be drastically reduced for the drug to be cost-effective.
Off-label use of intravitreal bevacizumab has become a widespread treatment for neovascular age-related macular degeneration. Although the drug is not FDA-approved for non-oncologic uses, some studies[which?] suggest that bevacizumab is effective in increasing visual acuity with low rates of ocular adverse effects. However, due to small sample size and lack of randomized control trial, the result is not conclusive.
In October 2006, the National Eye Institute (NEI) of the National Institutes of Health (NIH) announced that it would fund a comparative study trial of ranibizumab and bevacizumab to assess the relative efficacy and ocular adversity in treating wet AMD. This study, called the Comparison of Age-Related Macular Degeneration Treatment Trials (CATT Study), will enroll about 1,200 patients with newly diagnosed wet AMD, randomly assigning the patients to different treatment groups.
By May 2012, anti-VEGF treatment with Avastin has been accepted by Medicare, is quite reasonably priced, and effective. Lucentis has a similar but smaller molecular structure to Avastin, and is FDA-approved (2006) for treating MacD, yet remains more costly, as is the more recent (approved in 2011) EYLEA (aflibercept). Tests on these treatments are ongoing relative to the efficacy of one over another.
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