Distorted vision of a patient with vitreomacular traction (photo provided by Alcon)
Alcon’s Jetrea is on course to become the first NICE-backed non-surgical treatment available on the NHS in England and Wales for the rare eye condition vitreomacular traction after it was given a provisional recommendation by the cost effectiveness body.
The Institute’s draft guidance says that Jetrea (ocriplasmin) given as a one-time single eye injection was an efficient use of NHS resources to treat the condition, which involves the vitreous – the gel-like substance in the eye – pulling on the retina to distort vision and sometimes creating a hole in the macular area of the eye.
The recommendation only covers a limited group of patients with a serious form of vitreomacular traction, however, with NICE backing the use of Jetrea in patients with a macular hole greater than 400 micrometres in diameter who have severe symptoms and do not have the related eye complication epiretinal membrane.
This would be a more restricted use that allowed under its licence from the European Medicines Agency (EMA), which approved in March the use of Jetrea in any adult with the condition.
Nevertheless, the draft guidance will be welcome by the estimated 45,000 patients with vitreomacular traction in the UK, whose only previous option was a period of “watchful waiting”, involving a period of observation before becoming eligible for eye surgery.
This surgery is only reserved for patients with very serious deterioration in vision, and the recovery period involves lying face down for two weeks.
“Although vitrectomy surgery is usually effective in resolving vitreomacular traction, a patient expert described recovery as a very unpleasant process,” asserted Professor Carole Longson, Health Technology Evaluation Centre director at NICE.
“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.”
Alcon was acquired by Novartis in 2010 and now operates as the Swiss pharma company’s eyecare business. It purchased the rights to commercialise Jetrea outside the US from its developers ThromboGenics in 2012 as part of a deal potentially worth up to €375m.
In addition to its European licence, Jetrea won approval in October last year for the treatment of symptomatic vitreomacular adhesion.