The NHS has won a landmark High Court battle with two multinational drug companies - which could lead to savings of hundreds of millions of pounds a year.
A judge in London rejected an action brought by Bayer and Novartis against 12 NHS clinical commissioning groups (CCG's) in the north of England relating to a drug to treat the biggest cause of age-related vision loss in the UK.
Mrs Justice Whipple said on Friday that the companies challenged the lawfulness of a policy adopted by the groups which stated that Avastin would be offered to certain patients with wet age-related macular degeneration (wet AMD) "as the preferred treatment option".
The judge said the groups adopted the policy because of the "significant difference" in price between Avastin and medicines sold by the companies.
The condition, which currently affects tens of thousands of people in the UK, is currently treated using either Lucentis, sold by Novartis, or Eylea, sold by Bayer.
The companies challenged the policy on a number of grounds - including that the supply of Avastin to treat wet AMD patients was unlawful under EU law and because Avastin does not have a marketing authorisation for ophthalmic use.
Announcing her decision, the judge dismissed all grounds put forward by the companies and ruled that the policy adopted by the groups was lawful.
The ruling, which is said to have opened the way for patients across the country to be offered Avastin as an alternative to the other treatments, was welcomed by health leaders and clinicians.
Dr David Hambleton, CCG chief officer in South Tyneside, former consultant geriatrician and lead on behalf of the North East and North Cumbria CCG Forum, said: "We are absolutely delighted that we are now in a position to offer Avastin as an alternative treatment for wet AMD to our patients across the North East and North Cumbria.
"The drug is undeniably equally effective, and much less expensive, and the money this will save - in excess of £13.5 million per year for the 12 CCGs involved in this litigation alone, and hundreds of millions of pounds across the country - can be ploughed straight back into delivering the very best care possible to our patients.
"Here in the North, that's enough to pay for an extra 270 nurses or 266 heart transplants every year, and in a financially stretched NHS that could be life-changing for thousands of our patients.
"Novartis and Bayer have argued long and hard for the more expensive drugs they'd rather sell to be the only ones available to people suffering from this condition, but thankfully, the court has recognised that there is no medical basis to that argument.
"This is great news for patients with this condition and for the wider NHS. It's a victory for common sense over commercial interests."
Dr Hambleton continued: "The sooner all NHS Trusts implement a policy to offer Avastin as an option for the treatment of wet AMD, the sooner we can start to redirect that money into other resources and equipment so we can continue to make improvements to care which have life-changing benefits for our patients.
"It is right to offer our patients this choice, because the beneficiaries will be their friends, neighbours and family members."