The Surrey Heartlands Integrated Care System Area Prescribing Committee (APC) has agreed to support the use of biosimilar ranibizumab to the Surrey Heartlands Health economy in the following licensed indications, in line with the National commissioning recommendations following the national procurement for medical retinal vascular medicines
- Wet Age-Related Macular degeneration (Wet AMD)
- Central Retinal Vein Occlusion (CRVO)
- Branch Retinal Vein Occlusion (BRVO)
- Diabetic Macular Oedema (DMO)
- Myopic Choroidal Revascularisation (CNV)
Ranibizumab biosimilar should be used (in line with original NICE guidance) instead of the originator ranibizumab (Lucentis®) where this is clinically appropriate and there is capacity to do so. If ranibizumab biosimilar is contraindicated or not clinically appropriate for the specific patient or there are specific clinical considerations then, subject to the criteria specified in the relevant NICE technology appraisal guidance, clinicians should consider aflibercept, brolucizumab or faricimab.
Originator ranibizumab should not be used for new initiations
Clinicians should consider switching patients on originator ranibizumab to biosimilar ranibizumab with patient consent.
The PCN recommends ranibizumab (Lucentis®) as a treatment option for the first line treatment of visual impairment caused by macular oedema secondary to branch or central retinal vein occlusion in line with NICE TA 283 (May 2013) and the NICE FAQ document relating to local formularies (link to document below). Ranibizumab will be considered RED on the traffic light system.
NICE guidance TA283 was published in May 2013 for Ranibizumab for Macular Oedema (Retinal vein occlusion) and implementation of this guidance took place in August 2013.
