Eylea^® (aflibercept) 114.3 mg/ml (8 mg) did not meet the AWMSG criteria for health technology assessment as it was included on the NICE work programme. As part of the NICE process Eylea^® 8 mg was not progressed at topic selection stage and the following statement was issued: 'During the NICE topic selection process, decision makers noted that aflibercept 8mg is clinically equivalent and of at least equal cost-effectiveness to the NICE recommended aflibercept 2mg formulation (TA346 and TA294). Therefore, it would not be an efficient use of NHS resources to conduct an evaluation. Aflibercept 8mg should therefore be considered for routine commissioning.'

NICE TA346 and TA294 recommend aflibercept 2 mg subject to the specific criteria outlined; this includes that the manufacturer provides aflibercept with the discount agreed in the patient access scheme (PAS). In NHS Wales, health boards may consider a local formulary decision whether to make Eylea^® 8 mg available for prescribing in line with the specific criteria in NICE TA346 and TA294, providing the unit price is the same or lower than the current commercial price for Eylea^® 2 mg formulations. All commercial pricing should be agreed and provided through the All Wales Drug Contract.

Where formulary committees consider aflibercept 8mg, committees are encouraged to review the annual treatment costs compared to alternative licensed and NICE approved treatments, including aflibercept 2mg. This should include treat and extend data, adverse effect profiles, and future biosimilars to ensure cost-effective use of treatments within their health board.