Novartis's costly eye drug Lucentis has been rejected for another new use by NICE, following a similar setback in July.
The National Institute for Health and Clinical Excellence (NICE) said on Thursday its preliminary recommendation was against using Lucentis for visual impairment caused by macular oedema secondary to central or branch retinal vein occlusion.
NICE, which decides if particular treatments should be used on the state-run health service, had previously rejected Lucentis for diabetic macular oedema.
Macular oedema is caused by fluid collecting in the central part of the retina, leading to blurred central vision and other problems.
The cost watchdog said Lucentis could not be recommended because of gaps and uncertainties in the evidence on its effectiveness compared with other treatments.
The drug, which is injected into the eye, is still recommended for wet age-related macular degeneration, although its use in this condition has sparked debate because low doses of Roche's Avastin work in a similar way and cost a fraction of the price.
Future Lucentis sales had looked very uncertain earlier this year ahead of a head-to-head trial comparing it with Avastin. In the event, the trial results showed that although Avastin was just as effective, it had more side effects, going some way to protecting Lucentis.
Lucentis costs 742.17 pounds per injection.
($1 = 0.6391 British pounds)
(Reporting by Ben Hirschler; Editing by Helen Massy-Beresford)