The National Institute for Health and Care Excellence (NICE) has issued technology appraisal guidance recommending several medicines for use in the treatment of wet age-related macular generation. The National Health Service in England is legally required to fund medicines in line with NICE’s recommendations, normally within three months of the publication of final guidance.

NICE has also published a clinical guideline that provides comprehensive guidance on best practice in the management of patients with this condition, which is available at the following link:

https://www.nice.org.uk/guidance/ng82

NICE clinical guidelines are not mandatory, but NHS commissioners are expected to take them fully into account in ensuring that local services meet the needs of their populations.

The Medical Research Council (MRC), which is part of UK Research and Innovation (UKRI), funds research into vision loss, including age-related macular degeneration (AMD), through a range of schemes. This research spans discovery science and fundamental mechanistic understanding, through to new approaches for diagnosis and intervention. For example, MRC has committed over £4 million to Kings College University for a clinical trial to establish safety and efficacy of photoreceptor transplantation in retinal degeneration and AMD patients as a potential treatment of the condition.

The Advanced Research and Invention Agency (ARIA) has maximum autonomy over its research and project choice, and allocation of funding to research projects and different sectors will be decided by those with relevant technical expertise. ARIA has made nearly £530 million in funding available across its first 10 programmes, which includes biomedical research.

The Department funds research on health and social care through the National Institute for Health and Care Research (NIHR). Research funds are not usually ringfenced into specific conditions and there is not a target for research funding into age-related macular degeneration. However, the NIHR welcomes funding applications for research into any aspect of human health and care, including age-related macular degeneration. Our approach to funding research is through open and fair competition and peer review to ensure that the highest-quality proposals, most likely to deliver real impact for patients, are funded without imposing financial targets or limits. Further information is available at the following link:

https://www.nihr.ac.uk/get-involved/suggest-a-research-topic

The nature of research means it is difficult to provide a precise assessment on impact against specific conditions, although there have been times when it has responded to Government commitments to spend pre-specified amounts of money on research in particular areas. In the last five financial years the NIHR has awarded £26.2 million on eye research which has included £6.2 million on Age Related Macular Degeneration

The Department has not made a specific comparative estimate of the cost to the National Health Service and adult social care of age‑related macular degeneration‑related sight loss. Whilst it is not possible to estimate the potential cost savings from increased funding for specific preventative and curative research, the National Institute for Health and Care Research (NIHR) provides a large economic return to society. For every £1 invested in NIHR research, over £13 of economic benefit is returned to the nation.

The Department invests over £1.6 billion each year on research through the National Institute for Health and Care Research. In the last five financial years it has awarded £26.2 million on eye research which has included £6.2 million on age related macular degeneration.

The Department has not made an assessment. There are no approved medicinal products in the United Kingdom with apolipoprotein M, and there is no specifically approved product for macular degeneration that is known to act mainly by increasing apolipoprotein M.

If a company were to develop such a medicine, they would need to apply for a licence to the Medicines and Healthcare products Regulatory Agency. The medicine would be assessed for safety, quality, and efficacy before it could be granted a marketing authorisation in order to be appraised by the National Institute for Health and Care Excellence for routine National Health Service use.

The classification codes required to identify pathways where patients may have glaucoma or macular degeneration do not allow for distinction between the two conditions. The following table provides an estimate of the number of patients who have been waiting longer than 18 weeks for treatment specifically for wet macular degeneration and glaucoma in England, Merseyside, and Liverpool, via the latter’s integrated care boards (ICBs), as a snapshot for the week ending 27 April 2025, extracted on 8 May 2025:

Source: Waiting List Minimum Data Set, NHS England.

However, these figures may include patients that also have other conditions, as full coding for glaucoma and macular degeneration procedures requires diagnostic codes that are not available in the Waiting List Minimum Data Set.

The Department of Health and Social Care funds medical research through the National Institute for Health and Care Research (NIHR). The NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology was awarded £20 million funding for a five-year period starting from December 2022.

UKRI’s Medical Research Council (MRC) also plays a key role in funding underpinning research which may not be attributable to a specific condition but will benefit medical research more generally. UKRI delivers a substantial portfolio of researcher-led projects. This includes a wide variety of areas including physiological, biological, and mechanistic aspects that are applicable to many eye diseases and disorders of vision.

Details of UKRI and NIHR funding on specific areas is provided in the table below:

The Department of Health and Social Care funds medical research through the National Institute for Health and Care Research (NIHR). The NIHR Biomedical Research Centre at Moorfields Eye Hospital NHS Foundation Trust and UCL Institute of Ophthalmology was awarded £20 million funding for a five-year period starting from December 2022.

UKRI’s Medical Research Council (MRC) also plays a key role in funding underpinning research which may not be attributable to a specific condition but will benefit medical research more generally. UKRI delivers a substantial portfolio of researcher-led projects. This includes a wide variety of areas including physiological, biological, and mechanistic aspects that are applicable to many eye diseases and disorders of vision.

Details of UKRI and NIHR funding on specific areas is provided in the table below:

The classification codes required to identify pathways where patients may have glaucoma or macular degeneration do not allow for distinction between the two conditions.

The following table provides an estimate of the number of patients who have been waiting longer than 18 weeks for treatment specifically for wet macular degeneration and glaucoma in England, Merseyside, and Liverpool, via the latter’s integrated care boards (ICBs), as a snapshot for the week ending 10 November 2024, extracted on 15 November 2024:

Source: Waiting List Minimum Data Set (WLMDS), NHS England.

However, these figures may include patients that also have other conditions, as full coding for glaucoma and macular degeneration procedures requires diagnostic codes that are not available in the WLMDS.

The WLMDS is weekly management information that is subject to less validation than the monthly official statistics. There may be issues regarding the quality and completeness of the recorded data, which is not routinely reviewed centrally.

The Medicines and Healthcare products Regulatory Agency (MHRA) is currently supporting clinical trials for a number of medicines relating to geographic atrophy, including intravitreal injections. It will review the quality, safety and efficacy of these products should the manufacturers apply for licenses.

All new licensed medicines are subsequently appraised by the National Institute for Health and Care Excellence (NICE) and guidance issued to the National Health Service. In the absence of NICE’s guidance, local commissioners should consider the available evidence when determining funding for new treatments and the capacity of the local NHS to deliver the service.

The Medicines and Healthcare products Regulatory Agency (MHRA) is currently supporting clinical trials for medicines relating to geographic atrophy, including intravitreal injections, and will review the quality, safety and efficacy of these products should the manufacturers apply for licences.

All new licensed medicines are then appraised by the National Institute for Health and Care Excellence (NICE), with guidance issued shortly thereafter. In the absence of NICE’s guidance, local commissioners should consider the evidence available, with the infrastructure and resources needed locally before determining whether to fund new treatments. This will include consideration of the local National Health Service’s capacity to deliver the treatment.

The Medicines and Healthcare products Regulatory Agency (MHRA) is currently supporting clinical trials for medicines relating to geographic atrophy, including intravitreal injections, and will review the quality, safety and efficacy of these products should the manufacturers apply for licences.

All new licensed medicines are then appraised by the National Institute for Health and Care Excellence (NICE), with guidance issued shortly thereafter. In the absence of NICE’s guidance, local commissioners should consider the evidence available, with the infrastructure and resources needed locally before determining whether to fund new treatments. This will include consideration of the local National Health Service’s capacity to deliver the treatment.

Local authorities are required to undertake a needs assessment for any individual who appears to have a need for care and support. If a person is assessed as having eligible care and support needs, the local authority has a legal duty to meet these needs and design a support plan on how these needs will be met, subject to a financial assessment.

Specialists and eye clinic liaison officer can also provide personalised support, in particular for patients newly diagnosed with sight loss, such has rehabilitation services. Further practical support may be provided through a referral to a low vision clinic.

The Medicines and Healthcare products Regulatory Agency is currently supporting clinical trials for a number of medicines relating to geographic atrophy and will review the quality, safety and efficacy of these products should the manufacturers apply for licences.

The early adoption of new treatments, including for patients with geographic atrophy, is being supported by the Innovative Licensing and Access Pathway, which is enabling the rapid review and approval of promising new medicines. The recently launched Innovative Medicines Fund will also allow patients to benefit from early access to such treatments.

The National Health Service continues to prioritise urgent treatment for sight-threatening eye conditions, such as wet age-related macular degeneration, whilst the pandemic impacts services.

Macular services often have specific commissioner-established targets based upon the treatment of patients in line with best practice, ensuring that patients receive high quality treatment.

In addition to personalised support from specialists, the nhs.uk website provides details on support available for individuals suffering from age-related macular degeneration, including support groups such as the Macular Society support services and the Royal National Institute of Blind People advice service. Information is available at the following link:

https://www.nhs.uk/conditions/age-related-macular-degeneration-amd/living-with-amd/

Stem cell treatments for macular degeneration are in an early experimental phase of development. The National Institute for Health Research Clinical Research Network has supported a recent study (2015-2019­) producing stem cells to treat age-related macular degeneration and the Clinical Research Facility Network have supported 3 studies on macular degeneration and regenerative medicine and therapeutics in the past 5 years.