Those in favour of offering patients this choice, such as David Hambleton, chief executive officer of NHS South Tyneside CCG, one of 12 CCG’s involved in the legal dispute/case, argue: ‘We believe that they [patients] will support very strongly having a cost-effective, safe treatment and saving the NHS generally a lot of money. It is a victory for common sense over commercial interests’ [2]. Those in opposition, the drug companies Bayer and Novartis counter argue that ‘This sets a dangerous precedent, which we should all be concerned about. Today, people living with wet AMD are now being asked to compromise on the assured quality and safety of their treatment, purely on the basis of cost. This is inappropriate and unnecessary’ [3]. What is missing from this debate are the voices of the patients themselves. We conducted a survey questionnaire (see appendix 1) to determine directly from patients attending IVT clinic for wet AMD treatment (n = 38) with either Lucentis or Eylea, how they viewed the Avastin High Court Ruling, its consequence and likely impact for their eye health.

We found a variable response as to the underlying concerns governing patient choice when considering IVT treatment. No single domain assessed was unanimously of importance or unimportance to patients, rather participants agreed or disagreed across parameters randomly (See  Fig. 1). This is interesting, as it highlights just how diverse the concerns of patients undergoing IVT treatment can be. Most patients, after all, are not medically trained to evaluate the treatment they receive and so it is reasonable that varying ideas, concerns and expectations should abound and co-exist. This suggests that planning IVT services in line with patient choice may be a more complicated matter than those debating over clinical policy assume.

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