New PBS listings for the treatment of Age-related Macular Degeneration
6 June 2007
Ranibizumab (LUCENTIS®) is to be listed on the PBS on 1 August 2007 for the treatment of Age Related Macular Degeneration.
What is Lucentis?
LUCENTIS® (ranibizumab) is a new drug that will be listed on the Pharmaceutical Benefits Scheme from 1 August 2007 for the treatment of wet age related macular degeneration.
LUCENTIS® is administered by injection into the affected eye. The procedure to administer LUCENTIS® is performed by an eye specialist as a course of regularly scheduled injections.
What is age-related macular degeneration?
Age-related macular degeneration (AMD) is the name given to a group of degenerative diseases of the retina that cause progressive, painless loss of central vision. AMD affects a person's ability to see fine detail, drive, read, and recognise faces. In 2006, approximately 129,000 people were affected by the condition. This figure is expected to increase to 153,000 people by 2011.
There are two main forms of age related macular degeneration. The wet or neovascular form of the disease, which affects around half the population with AMD, causes scarring and loss of vision. If left undetected or untreated, rapid and severe loss of central vision can occur within a short period of time. The dry form of the disease is a slower form that causes gradual vision loss and cannot be treated.
What does LUCENTIS do?
LUCENTIS® is a new therapy that can slow the progress of AMD and in some cases restore some vision. For some patients this will be the difference between driving or not driving, being able to read a newspaper or book and undertake other daily activities without assistance.
Who will benefit?
It is expected that around 11,500 new patients will commence treatment with LUCENTIS® in the first full financial year of listing, increasing to 15,000 new patients by the fourth year.
The numbers of new patients expected to be treated each year takes into account estimates regarding progression of the disease, the numbers of patients likely to achieve a long term benefit, expected rates of compliance and patients who will continue on alternative treatment with VISUDYNE®.
When will this new treatment become available?
LUCENTIS® is being listed on the PBS on 1 August 2007.
How much will LUCENTIS® cost the patient?
A patient who is treated with LUCENTIS® through the PBS will meet only the standard co‑payments of $30.70 for general patients and $4.90 for concessional patients. General patients who have reached the PBS safety net threshold will receive LUCENTIS® at the concessional rate of $4.90, while concessional patients will receive LUCENTIS® free of charge once the safety net threshold has been reached.
What will happen to the VISUDYNE® Program?
Since 2002, VISUDYNE® (verteporfin) has been available through Medicare for the treatment of wet age related macular degeneration. From 1 August 2007, this treatment will be transferred to the PBS.
While VISUDYNE® will largely be replaced by LUCENTIS® as the most likely treatment option for the majority of patients, there remains a place for VISUDYNE® as a preferred therapy for some patients. These patients will now be able to be treated on the PBS.
What is the cost to Government?
The cost to Government of providing LUCENTIS® to the average patient each year is approximately $11,700 and for VISUDYNE®, approximately $5,000.
The total cost over the next four years of listing LUCENTIS® on the PBS and the Repatriation Pharmaceutical Benefits Scheme (RPBS) and transferring VISUDYNE® to the PBS and RPBS is expected to be $629.5 million.