We’ve discussed the scandal over the use of Avastin and Lucentis for wet macular degeneration several times (here, here, here). If you’ve missed it, here’s the gist. Avastin is a drug approved to treat colon cancer. It works by choking off blood vessels to the tumor. It turns out, however, that a tiny dose of the same drug, when injected into the eye can also stop the uncontrolled growth of blood vessels behind the retina that produces a leading cause of blindness in the elderly, macular degeneration. The good news is a compounding pharmacy can take the large dose in the Avastin package and split it into sterile eyeball-appropriate doses. The cost is somewhere between $20 and $100. That’s good news for consumers, anyway. It wasn’t such good news for Genentech, the maker of Avastin. So they went about making a small modification of the drug, renamed it Lucentis, and got FDA approval for its use in macular degeneration — at $2000 per monthly injection. Avastin is not approved for the same purpose because Genentech has not applied for approval. It’s still legal to use it off label, however, and numerous ophthalmologists have been doing so to save their patients and the taxpayers’ money.
Genentech was not amused. So they announced in October they would no longer sell Avastin to compounding pharmacists. There was an immediate and vigorous reaction from doctors (good for them!). Now the New York Times has reported the two sides have reached a compromise, of sorts:
But Genentech and two associations for eye doctors announced that doctors would be able to order Avastin themselves but have the drug delivered to compounding pharmacies.
That would allow access to the drug, but would allow Genentech to stop selling the drug to compounding pharmacies. The company said the sales to the pharmacies had provoked concerns at the Food and Drug Administration because Avastin is not made for use in the eye.
In an e-mail message sent to their members on Thursday, the American Academy of Ophthalmology and the American Society of Retina Specialists said they believed the plan “addressed the needs of most of their members.” However, regulations vary by state, the groups said. (New York Times)
This arrangement forces an extra step for the doctor, the patient and the pharmacy. It is unnecessary but better than the alternative, as long as this arrangement lasts. Look for Genentech to try again to shut off the supply of Avastin for macular degeneration.
Big Pharma is not about saving lives or vision. It’s about making money. Merry Christmas.