Mohamed et al. [1] surveyed a small number of consultants to identify key areas of concern regarding Avastin use in wet AMD. Nearly 40% thought that patient understanding and misinformation would be a big challenge in offering Avastin. We conducted a survey of our patients currently receiving treatment for wet AMD. We provided information about NICE guidelines, the GMC, and the regulatory authorities that licence drugs, attempting to explain the issues around Avastin in about 220 words (Appendix 1). We received 87 replies, with 77% saying they would be happy to switch to Avastin based on the information provided. The main reasons for this positive response were that it would save money and had the same results as the more expensive drugs. Nine percent said they would not be willing to switch. The concerns stated were that patients did not want to switch from their current drug, which was working well, and concern about the lack of regulatory processes of Avastin.

Eleven percent of patients wanted more information than we provided in the original 220 words in order to make the decision. The additional information requested related to interference with current medication taken for other long-term conditions, and potential side effects. We consider that these questions could be addressed relatively easily in a face-to-face consultation that would take place when prescribing decisions were being considered.

Our survey suggests there is good understanding of the issues surrounding the prescription of Avastin with a relatively short explanation. Many patients stated that they were previously aware of this through media sources. Although the consultants in Mohamed et al.’s survey felt that patient understanding was a big challenge, our survey suggests that patients are broadly supportive of the use of Avastin and can understand the issues with a relatively short explanation. We do consider that additional resources will be required to ensure that patients can make fully informed choices about their anti-VEGF treatment.