11.6. High Cost Drugs - (Retinal Disorders)

High Cost Tariff Excluded Drugs - Retinal Disorders

For the Kent and Medway Health Economy National Tariff Excluded Drugs Manual
(HIGH COST DRUGS Page) Click Here

These drugs or devices are only commissioned for those indications listed under the individual drug. With regard to items commissioned by ICB, drugs or devices may not be commissioned across every ICB.

Aflibercept (Eylea®)	This High-Cost Drug has been approved for the following indications:- Treatment of neovascular age-related macular degeneration (nAMD) and Macular oedema due to diabetes (DMO)
For Eye Guidance & Information Page Click Here	Aflibercept 114.3 mg/mL (8mg/0.07ml) solution for injection (in a vial presentation) via intravitreal administration ICB commissioned - approval via Blueteq

Brolucizumab (Beovu®)

This High-Cost Drug has been approved for the following indications:-

For Eye Guidance & Information Page
Click Here

For treating visual impairment due to diabetic macular oedema in adults, only if:
• the eye has a central retinal thickness of 400 micrometres or more at the start of treatment.
Brolucizumab will be reserved as a last line treatment option following failure to either aflibercept, faricimab and ranibizumab.

Brolucizumab for treating diabetic macular oedema NICE Guidance TA820
ICB commissioned - approval via Blueteq

Dexamethasone intravitreal implant (Ozurdex^®)

This High-Cost Drug has been approved for the following indications:-

For Eye Guidance & Information Page
Click Here

For treating visual impairment caused by diabetic macular oedema in adults (DMO) only if:-
• their condition has not responded well enough to, or if they cannot have non-corticosteroid therapy.

Dexamethasone intravitreal implant for treating diabetic macular oedema NICE Guidance TA824
ICB commissioned - approval via Blueteq

Faricimab (Vabysmo®)	This High-Cost Drug has been approved for the following indications:-
For Eye Guidance & Information Page Click Here	For treating visual impairment due to diabetic macular oedema in adults, only if: • the eye has a central retinal thickness of 400 micrometres or more at the start of treatment Faricimab for treating diabetic macular oedema NICE Guidance TA799 ICB commissioned - approval via Blueteq
	For treating wet age-related macular degeneration in adults, only if: • the eye has a best-corrected visual acuity between 6/12 and 6/96 • there is no permanent structural damage to the central fovea • the lesion size is 12 disc areas or less in greatest linear dimension. • there are signs of recent disease progression (for example, blood vessel growth as shown by fluorescein angiography, or recent visual acuity changes) Faricimab for treating wet age-related macular degeneration NICE Guidance TA800 ICB commissioned - approval via Blueteq
	For treating visual impairment caused by macular oedema after retinal vein occlusion Faricimab for treating visual impairment caused by macular oedema after retinal vein occlusion NICE Guidance TA1004

Fluocinolone acetonide (Iluvien®)

This High-Cost Drug has been approved for the following indications:-

For Eye Guidance & Information Page
Click Here

For treating chronic diabetic macular oedema that has not responded well enough to available treatments in adults.

Fluocinolone acetonide intravitreal implant for treating chronic diabetic macular oedema NICE Guidance TA953
ICB commissioned - approval via Blueteq

Ranibizumab Biosimilar (Lucentis®/ Ongavia®/Rimmyrah®)

This High-Cost Drug has been approved for the following indications:-

For Eye Guidance & Information Page
Click Here

For the treatment of wet age-related macular degeneration if:
• all of the following circumstances apply in the eye to be treated:
• the best-corrected visual acuity is between 6/12 and 6/96
• there is no permanent structural damage to the central fovea
•the lesion size is less than or equal to 12 disc areas in greatest linear dimension
•there is evidence of recent presumed disease progression (blood vessel growth, as indicated by fluorescein angiography, or recent visual acuity changes)

Ranibizumab and pegaptanib for the treatment of age-related macular degeneration NICE Guidance TA155
ICB commissioned - approval via Blueteq

For treating visual impairment caused by macular oedema:
• Following central retinal vein occlusion or
• following branch retinal vein occlusion only if treatment with laser photocoagulation has not been beneficial, or when laser photocoagulation is not suitable because of the extent of macular haemorrhage

Ranibizumab for treating visual impairment caused by macular oedema secondary to retinal vein occlusion NICE Guidance TA283
ICB commissioned - approval via Blueteq

For treating visual impairment due to diabetic macular oedema only if:
• the eye has a central retinal thickness of 400 micrometres or more at the start of treatment

Ranibizumab for treating diabetic macular oedema NICE Guidance TA274
ICB commissioned - approval via Blueteq

For treating visual impairment due to choroidal neovascularisation secondary to pathological myopia

Ranibizumab for treating choroidal neovascularisation associated with pathological myopia NICE Guidance TA298
ICB commissioned - approval via Blueteq

First Line Choice
On Formulary
Specialist Initiation Only

Hospital Only
KMPT Initiation Only