Faricimab is recommended, within its marketing authorisation, as an option for treating visual impairment caused by macular oedema after central or branch retinal vein occlusion in adults. It is only recommended if the company provides it according to the commercial arrangement.
If people with the condition and their healthcare professional consider faricimab to be 1 of a range of suitable treatments, after discussing the advantages and disadvantages of all the options, the least expensive should be used. Administration costs, dosages, price per dose and commercial arrangements should all be taken into account.
Why these recommendations were made
Visual impairment caused by macular oedema after retinal vein occlusion is usually treated with an anti-vascular endothelial growth factor (anti‑VEGF) treatment (aflibercept or ranibizumab). Faricimab is another treatment option that works in a similar way and would be offered to the same population.
Using NICE's cost comparison methods, if a treatment has similar benefits and costs to a comparator recommended in technology appraisal guidance it can be recommended as a treatment option.
Evidence from clinical trials shows that faricimab is likely to work as well as aflibercept for people who have not had an anti‑VEGF treatment. There is limited evidence for how well faricimab works for people who have had an anti‑VEGF treatment. But clinical experts agreed that faricimab is likely to work as well as aflibercept for people who have had an anti‑VEGF treatment.
A cost comparison suggests faricimab has similar costs and overall health benefits to aflibercept. In addition, a majority of people currently have aflibercept for this condition, particularly people starting treatment. So faricimab is recommended as an additional treatment option.
There are no equality issues relevant to the recommendations.
For all evidence see the committee papers. For more information on NICE's evaluation of aflibercept, see the consideration of the evidence section in NICE's technology appraisal guidance on aflibercept for treating visual impairment caused by macular oedema secondary to central retinal vein occlusion, and the committee discussion section in aflibercept for treating visual impairment caused by macular oedema after branch retinal vein occlusion.