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Doctors should put patients over cost

15 Nov 2013

By Lloyd Mudiwa

Doctors should always try to do the best they can for their patients without the consideration of cost, a leading ophthalmologist has said.

The Full Professor and Chair at the Department of Ophthalmology, University Vita-Salute, Scientific Institute, San Raffaele, Milan, Italy — described by the Irish College of Ophthalmologists (ICO) as one of the world’s top ophthalmic experts — commented: “Our role should not be to ask for less for our patients. As doctors, we work for the best for our patients, then someone else with responsibility for allocation of resources should worry about feasibility, maybe a politician.”

Prof Francesco Bandello, in Dublin last month for the International Retina and AMD Congress 2013, was commenting on the ongoing debate in the specialty — whether to prescribe Avastin (bevacizumab), a cheaper off-label drug originally licensed for cancer, or the relatively more expensive licensed Lucentis (ranibizumab), for the treatment of wet Age-related Macular Degeneration (AMD).

Irish Medical Times reports as the results of a ground-breaking investigation into the prevalence of the chronic eye condition in Ireland (some 7 per cent of over 50-year-olds have AMD) were presented by Principal Investigator of the Macular Pigment Research Group, Waterford IT, Prof John Nolan, at the International Retina Conference hosted in Dublin last week by Irish patient-led research charity Fighting Blindness.

However, Prof Bandello said: “The problem is financial. If we have enough money I think there is no question about it, we must use Lucentis, because it is developed specifically for ophthalmology with less side-effects. But if we have insufficient money, then it should be about watching the costs.”

Although he believes Avastin works equally well, Prof Bandello queried: “Were it your mother or brother or sister, you would give them Lucentis but what is the limit?”

Resources will become increasingly important in the future as people live longer and because all over the world nobody has money to treat everyone in the best possible way so we have become communistic, he observed.

15 November 2013

Click here to view the full article which appeared in Irish Medical Times