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Public hospitals will consider making a colon cancer drug the standard treatment for a blindness-causing eye condition if a one-year clinical trial on more than 500 patients can prove its safety and effectiveness. 
The trial of Avastin,  to begin mid-year, will be a collaboration between the University of Hong Kong and Chinese University and could drastically reduce the cost of treatment.
A senior Hospital Authority executive said that if the drug became standard treatment at hospitals for a type of age-related macular degeneration known as wet AMD, the cost of treatment would be about 1 per cent of a course of the drug registered for the condition, Lucentis. 
There has been a heated debate in the past months among medical professionals, patient groups and health authorities about the use of Avastin, which is only registered for use in treating colon cancer, on AMD. 
Public hospitals do not provide any subsidised therapy for AMD, apart from conventional surgery or laser treatment. If patients want to use either drug, they pay the full cost.
AMD is caused by deterioration of the central portion of the retina, the macula. The drugs are injected into the eye to repair the damage. 
The senior executive said Lucentis cost HK$8,300 per dose. Each patient needed at least three doses, given at four-week intervals, meaning a course cost HK$24,900. Avastin cost about HK$85 per dose, putting a three-shot course at HK$255. Some patients could need more than three shots, depending on their condition.
Private eye doctors started using Avastin to treat AMD in Hong Kong about three years ago. Such use is called 'off label', as it is not specified in the drug's licence. 
The College of Ophthalmologists and the Medical Association support the off-label use of Avastin for AMD. But the Practising Pharmacists Association and patient group Retina Hong Kong  say claims for Avastin's effectiveness are 'unfounded and not based on evidence'. 
The executive said the authority would use HK$12 million in government funds on the trial to compare the effectiveness of Lucentis and Avastin on more than 500 patients.
Approval from an ethics committee would be needed. He said overseas health systems, including in the United States, Canada, Britain and some European countries, were also conducting similar trials, with some results due by the end of the year.
'We will consider both overseas and local experience to decide if we will make Avastin a standard drug for public patients. We also need to do the local study to work out a treatment plan for patients,' he said.



Trial for drug to cut cost of eye therapy