The debate on Lucentis and Avastin
For those 200,000 AMD patients within an average year in US, the most effective treatment that approved by FDA is Lucentis. It brings hope to wet AMD patients by stopping and sometimes reversing vision loss, which is a huge breakthrough. Yet another drug that is similar to Lucentis is also under wide discussion, which is named Avastin. But Avastin is much cheaper than Lucentis, so that many doctors recommend Avastin for low-income individuals.
However, Avastin has not received FDA approval for ophthalmic uses. Based on safety issues, Genentech also restricts the sale of Avastin to compounding pharmacies for ocular uses. Both Lucentis and Avastin are owned by this company. Since the FDA has expressed no concern about the Avastin’s off label uses for AMD, many eye doctors argue that Genentech should allow Avastin to be directly sold to both physicians and compounding pharmacies. If only physicians have access to Avastin, doctors at the American Academy of Ophthalmology protest that many lower income people will be deprived of this sight-saving drug. The fact is that Lucentis cost an average of $2,000, while Avastin only needs $150.
During the widely off-label uses of Avastin, this treatment has not been proved to be as effective as Lucentis, or even more effective. No clinical study has made a comparison between the two AMD treatments. The most concern is their price discrepancy. Even if Medicare and other health insurance plans offset parts of the Lucentis expense, it is still much more expensive than Avastin. For example, patients with Medicare may only need to pay a 20% of co-payment for Lucentis, which equals about $400.
Genentech has given explanations about its different policies of the two drugs. Genentech officials say that the high price of Lucentis comes from its special development and its considerable expense of clinical trials. Lucentis is administered in the form of smaller molecules, which are more effective in controlling abnormal blood vessels. The company also claims that they will not conduct new trials for Avastin, since Lucentis has already got FDA approval and is a promising AMD solution. The good news may be that the US government is likely to fund the comparison between Lucentis and Avastin.
While the initial use of Avastin for colon and other cancers was reported to arouse risks of stroke and heart attack, its use for macular degeneration has brought no negative side effects. Most of the doctors are positive about the Avastin’s long-term safety risks. Due to its low price, researchers encourage the use of Avastin. There are also concerns that Avastin may be unable to penetrate the eye’s retina effectively. The undergoing two-year NEI clinical trails may settle down all these controversies.
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