This is being written up as the NHS having won a victory over the Big Bad Pharmaceutical Companies. When in fact it’s a failure of the Big Bad Pharmaceuticals Regulation System

.The NHS has won a landmark battle against drug giants paving the way for the health service to save millions by prescribing cheaper medicine.

Bayer and Novartis brought a High Court action against 12 NHS clinical commissioning groups (CCGs) in the north of England, relating to a drug to treat the biggest cause of age-related vision loss in the UK.

The companies challenged the lawfulness of a policy adopted by the groups which prescribed Avastin "as the preferred treatment option" for wet age-related macular degeneration (wet AMD).

Avastin, which costs around £28 per injection, is widely used around the world. However, despite being recommended by the World Health Organisation, it is only licensed for cancer treatment in the UK.

Yet the NHS groups were offering it as a course of treatment for patients with AMD alongside drugs called Lucentis and Eylea - drugs licensed for eye treatment.

Novartis and Bayer manufacture the two more expensive licensed drugs - Lucentis which costs £561 and Eylea which costs £800 a time.

Pretty much everything we know about Avastin does tell us that it’s just as good as the more expensive drugs. There have been proper tests of this contention.

However, it is not licenced for the treatment of this eye disease. It’s got all the documents and permissions to be used against certain cancers, but not in the eyes. Lucentis does have that eye licence. And it cost some hundreds of millions upwards to gain that licence for use in the eye as well. We’ve two different drugs (although we can have the most lovely arguments about how different they are) equally effective at treating this eye disease, one is licenced and expensive, the other is not for this purpose and is cheap.

This is Big Bad Pharma or a problem with the licencing system?