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Italian antitrust agency probes alleged Roche-Novartis cartel

Eye docs, clinics want to use Avastin, but Lucentis is the only approved option
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Italian antitrust watchdogs have entered the Avastin-vs.-Lucentis fray. The Italian Competition Authority opened an investigation of Roche ($RHHBY) and Novartis ($NVS) on suspicion of a "cartel" designed to preference the vision-loss drug Lucentis over Avastin, the cancer drug sometimes used off-label in eye treatments.

Italian Ophthalmological Society and an association of private healthcare facilities each filed a complaint alleging that Roche and Novartis might have an "illicit agreement" to keep Avastin out of the eye business. The filings claim that the alleged cartel costs hundreds of millions of euros per year. Roche developed Lucentis, and Novartis markets it in Europe.

Eye doctors often use Avastin off-label in patients with macular degeneration and other vision-robbing disorders. It's a far cheaper option than Lucentis, which was developed specifically for injection into the eye. And some researchers have found that the treatments are roughly equal, efficacy-wise, in patients with wet age-related macular degeneration.

But off-label Avastin use isn't without its risks; it has to be repackaged for eye use, and in the process can be contaminated. Several clusters of infections have cropped up in patients injected with Avastin, some of which caused vision loss. The same studies showed that more Avastin patients suffered adverse events than Lucentis patients.

Still, cost-conscious customers keep turning to Avastin--or trying to. The Italian probe is just the latest scrap over ophthalmic use of the drug. Some eye doctors in the U.S. raised a ruckus several years ago, claiming that Roche's Genentech unit had clamped down on distribution to keep Avastin out of their hands. More recently, Novartis prevailed in a fight over Avastin use by some doctors on the U.K.'s National Health Service; after offering a discount on Lucentis, the NHS doctors agreed to abandon off-label Avastin.

The competition agency visited the Italian offices of Roche and Novartis, looking for evidence, on Valentine's Day, the agency said in a statement. It plans to wrap up its probe by Dec. 20.

- see the competition authority's statement

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