1 Recommendations

1.1 Faricimab is recommended as an option for treating wet age-related macular degeneration in adults, only if:

the eye has a best-corrected visual acuity between 6/12 and 6/96
there is no permanent structural damage to the central fovea
the lesion size is 12 disc areas or less in greatest linear dimension
there are signs of recent disease progression (for example, blood vessel growth as shown by fluorescein angiography, or recent visual acuity changes)
the company provides faricimab according to the commercial arrangement.

1.2 If patients and their clinicians consider faricimab to be 1 of a range of suitable treatments (including aflibercept and ranibizumab), choose the least expensive treatment. Take account of administration costs, dosage, price per dose and commercial arrangements.

1.3 Only continue faricimab if an adequate response to treatment is maintained. Criteria for stopping should include persistent deterioration in visual acuity and anatomical changes in the retina.

1.4 These recommendations are not intended to affect treatment with faricimab that was started in the NHS before this guidance was published. People having treatment outside these recommendations may continue without change to the funding arrangements in place for them before this guidance was published, until they and their NHS clinician consider it appropriate to stop.

Why the committee made these recommendations

Wet age-related macular degeneration is usually treated with aflibercept or ranibizumab, which are already recommended by NICE for treating wet age-related macular degeneration. Faricimab is another treatment option that works in a similar way.

Evidence from clinical trials shows that faricimab is as effective as aflibercept. An indirect comparison of faricimab with ranibizumab also suggests similar clinical effectiveness.

A cost comparison suggests faricimab has similar costs and overall health benefits to aflibercept or ranibizumab. So, faricimab is recommended for treating wet age-related macular degeneration if it is used in the same population as aflibercept and ranibizumab.