Drug company treatments for macular degneration turn into a civil war

Say you have a serious disease and there are two drugs that can treat it. Both of the drugs are made by the same company, and they work equally well, but one costs $2,000 a treatment and the other $60. Which would you choose?

The answer seems obvious, but there are complications when it comes to the costlier Lucentis and the cheaper Avastin, the two drugs manufactured by San Francisco-based Genentech that are being used to treat wet macular degeneration.

Company executives did not respond to requests for an interview about the medicines. Instead, Terence Hurley, who asked to be identified as a Genentech spokesperson, sent an email that included this statement:

“The price of Lucentis allows us to continue discovering medicines for people with serious eye diseases. Genentech invested nearly a decade and hundreds of millions of dollars in the clinical development of Lucentis in wet AMD. It is one of the most expensive clinical trial programs Genentech has ever conducted.

“We will continue to invest in the science to allow us to continue discovering medicines for people with serious eye diseases.”

As for Avastin, Hurley said, “Genentech does not support or promote the use of Avastin for wet AMD or other eye conditions as it is off-label.”

The way Long Beach ophthalmologist Dr. Stanley Carson tells it, “Lucentis went though all the FDA trials to get approved for use in the eye. So the whole difference is because the company paid a


lot of money to run through the trials and experiments to satisfy the FDA. But they didn’t do it for Avastin.”

Carson means that although Genentech went through the same process to get Avastin approved for treating cancer, it never got the drug approved for treating macular degeneration.

How does Genentech feel about the civil war raging inside its family between two brother drugs? It isn’t saying, and to date, it still hasn’t done any research comparing the results of Lucentis and Avastin.

So the National Eye Institute commissioned its own research from February 2008 through December 2009, involving 1,208 patients age 50 and older at 44 clinical centers across the country. The results were published in the April edition of the New England Journal of Medicine. The bottom line was that both drugs were basically equally effective.

Genentech has not responded to the publication, but Hurley said, “We continue to believe that Lucentis is the most appropriate treatment for wet AMD.




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