NICE unsure of diabetes implant

NICE has failed to recommend Alimera’s Iluvien (fluocinolone acetonide intravitreal implant) for the treatment of chronic diabetic macular oedema (DMO) in draft guidance.

Its independent Appraisal Committee raised concerns over the economic model submitted by Alimera and the evidence it supplied during the appraisal.

Professor Carole Longson, Health Technology Evaluation Centre Director at NICE, said the Committee “agreed” that the evidence supplied “could not support a positive recommendation”.

Around 336,000 in the UK with diabetes have DMO. Prevalence increases to nearly a third (29%) of people with diabetes who have used insulin for more than 20 years.

DMO occurs as a result of changes in retinal blood vessels. Iluvien is a corticosteroid which has anti-inflammatory and anti-vascular endothelial growth factor (anti-VEGF) properties. By inhabiting VEGT, the implant can decrease the oedema and improve vision.

But NICE concluded economic models “underestimated” the incremental cost-effectiveness ratio for the treatment and that data supplied did not “accurately reflect” current clinical practice.

The draft recommendation is now open to consultation.