The must-read stories and debate in health policy and leadership.

A landmark legal victory for 12 northern clinical commissioning groups over two pharmaceutical giants has brought a sigh of relief for the NHS.

A high court judge rejected claims from Bayer and Novartis Pharmaceuticals UK that the CCGs were acting illegally in using the drug Avastin to treat patients suffering from the most common form of blindness.

Though typically used to treat cancer, Avastin has also been proven to help tackle wet age-related macular degeneration.

Avastin costs £28 per injection, whereas the companies hold the rights for alternative drugs, Eylea and Lucentis, which cost £816 and £551 respectively, the court heard.

Bayer and Novartis claimed patients were effectively being forced to use unlicensed medicines instead of their NICE-approved options. They said this undermined the regulatory framework and NHS constitution.

The CCGs claimed trials have shown Avastin is as safe and effective as other drugs and could save them £13.5m a year.

Other CCGs are now likely to follow suit, although it could take a while for the dust to settle, especially if Bayer and Novartis decide to appeal.

As the NHS continues to feel the financial pressure, commissioners will be wondering what other cheaper drugs they can offer patients to reduce their bills.

Show of support

There has been a show of support from HSJ readers for the outgoing chief executive of Countess of Chester Hospital Foundation Trust, where there’s been an ongoing police investigation into a string of baby deaths.

It is unclear exactly why Tony Chambers has gone, but he said in his departing statement: “Recent times have been particularly challenging for the hospital not least of which is the ongoing police investigation into an increase in mortality rates in our neonatal unit. My thoughts will continue to be with the bereaved families as they await the outcome of the police investigation.”

Several readers offered sympathy for Mr Chambers, who led the trust for six years, and suggested he had fallen victim to a tidal wave of bad news.

Andrew Foster, chief executive of Writhington, Wigan and Leigh Foundation Trust, said: “It’s tragic when a really good person gets caught up in a tsunami not of his own making. Tony is behaving very honourably and deserves all of our support. He has been a great chief executive.”