Response to NICE announcing final guidance for Ozurdex® for the treatment of visual impairment due to diabetic macular oedema (DMO)

22 July 2015

The Royal College of Ophthalmologists welcomes the Final Appraisal Determination (FAD) from NICE recommending Ozurdex® (dexamethasone intravitreal implant) as a clinically and cost effective treatment option for selected patients with visual impairment due to diabetic macular oedema (DMO).

In the final guidance, dexamethasone intravitreal implant is recommended as a treatment option in people if:

• the implant is to be used in an eye with an intraocular (pseudophakic) lens,  and
• their DMO does not respond to non-corticosteroid  treatment or such treatment is unsuitable.

This recommendation from NICE is an important step forward in providing further options for managing the significant visual loss experienced by patients with DMO.

The NICE guidance, which covers NHS England and Wales, contrasts with guidance for NHS Scotland by the Scottish Medicines Consortium which recommends Ozurdex® not only for pseudophakic patients but also for phakic patients who are considered insufficiently responsive to, or unsuitable for non-cortico-steroid therapy (published April 2015). Ophthalmologists responsible for patients in NHS England and Wales will have to apply to their local Clinical Commissioning Group (CCG) or Local Health Board (LHB) respectively as an individual funding request if they wish to use Ozurdex® in a phakic patient with DMO. Alternatively, they could work closely with their CCG or LHB to develop local funding arrangements for selected groups of individuals meeting certain predefined criteria.

We hope CCGs and LHBs will support the rapid implementation of the final guidance so patients can benefit from a further treatment option for this potentially debilitating condition.

Please find guidance here.