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A new health technology: where is the consensus on a clinically worthwhile benefit?
B Foot1, R Foy, U Chakravarthy
1The Royal College of Ophthalmologists London, UK. Barny.Foot@moorfielsd.nhs.uk
Eye (London, England)
|July 9, 2002
Summary
Photodynamic therapy (PDT) availability varies significantly across UK National Health Service (NHS) units for neovascular age-related macular degeneration. This inequitable provision highlights concerns about under-evaluated treatments and access to effective therapies.
Area of Science:
- Ophthalmology
- Health Services Research
Background:
- New therapies are often introduced into the NHS before full evaluation, causing provision inequities.
- Uncertainty surrounds the value of photodynamic therapy (PDT) for neovascular age-related macular degeneration (AMD).
Purpose of the Study:
- To ascertain the availability of PDT for neovascular AMD within the NHS.
- To identify the information sources influencing clinical policy for PDT adoption.
Main Methods:
- A UK-wide postal survey of clinical directors/lead consultants.
- Data collected on PDT referral/treatment rates, evidence sources, and justification thresholds.
Main Results:
- 42% of units provide some NHS PDT; 9% offer routine provision.
- Significant variation in the threshold for justifying PDT introduction.
- Local reviews, clinician advice, and industry information were key policy drivers, with NICE and Cochrane expected to gain influence.
Conclusions:
- Substantial variation exists in PDT availability, raising concerns about equitable access to potentially effective therapies.
- Patients may receive under-evaluated treatments, or effective therapies may be inequitably provided.
- Differing clinical justification thresholds may worsen variations in PDT provision and priority.