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Indication
Choroidal neovascularisation (CNV) associated with pathological myopia
RAG rating
Red
Document type
Decision document
Place
Hertfordshire and West Essex ICB
Output type
Pharmacy / Prescribing

Ranibizumab

HERTFORDSHIRE AND WEST ESSEX AREA PRESCRIBING COMMITTEE (HWE APC)

Aflibercept 2mg biosimilar and Ranibizumab biosimilar for Choroidal neovascularisation (CNV)

RED

Recommended for restricted prescribing by specialist only.

Not recommended for primary care prescribing.

Name generic (trade) Aflibercept 2mg biosimilar and Ranibizumab biosimilar

What it is Vascular endothelial growth factor A inhibitor (anti-VEGF)

Indication Choroidal neovascularisation (CNV) associated with pathological myopia

Date decision last revised January 2026

Decision status Final

NICE / SMC Guidance NICE TA 486 and NICE TA 298 recommended.

HWE APC recommendation:

Treatment options consistent with NICE TA recommendations for approved indications:

  • ranibizumab biosimilar and aflibercept 2mg biosimilar are the preferred first line anti-VEGF agents
  • aflibercept 2mg biosimilar is the preferred second line anti-VEGF agent if 1st line ranibizumab biosimilar used
  • clinicians should consider reviewing patients currently prescribed ranibizumab (Lucentis®) and aflibercept (Eylea) to assess suitability for a change to biosimilars

1. NHSE Operational note: Commissioning recommendations following the national procurement for medical retinal vascular medicines August 2022 v1.

Review date: The recommendation is based upon the evidence available at the time of publication. This recommendation will be reviewed upon request in the light of new evidence becoming available.

 

Updated August 2025 to reflect availability of aflibercept 2mg biosimilar Q3 2025 and updated wet AMD prescribing guideline, approved July 2025 APC. Updated January 2026 to reflect the diabetic macular oedema guideline and macular oedema secondary to retinal vein occlusion guideline, approved December 2025 APC.

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