As researchers in the U.S. compare Genentech's macular degeneration drug, Lucentis, with Avastin, another Genentech drug used off-label to treat the eye disease, notoriously tight-fisted regulators in the UK are clearing the much more expensive Lucentis for funding by the National Health Service.
As you know, Genentech has run into controversy over Lucentis, which costs $2,000 per treatment, versus $60 per dose for Avastin when used for the eye malady. The company had moved to restrict distribution of Avastin to compounding pharmacies that repackage the drug for ophthalmic use, but the outcry from doctors and patients led Genentech to soften its stance.
Genentech has come in for criticism from the National Eye Institute, which wanted the company to be part of the head-to-head study. Unsurprisingly, the company wasn't eager to sink money into a trial that pitted two of its drugs against each other--but some have read that refusal as evidence of the company's lack of faith that Lucentis will prevail.
Most importantly, though the study results won't be available for a couple of years, folks are already talking about the prospect that, if the drugs prove comparable at treating macular degeneration, Medicare would refuse to pay any more for Lucentis than it does for Avastin.
In the U.K., however, the National Institute for Clinical Excellence has decided to make Lucentis available to NHS patients. The series of 14 injections will run about $18,000 per eye; under its deal with NICE, Novartis, which markets the drug in Europe, will cover any additional injections needed. Even at the $18,000 cost, NICE figures it will save money compared with the cost of patients' vision impairment.
Why didn't NICE recommend Avastin instead? There's no trial data showing the drug's effectiveness against macular degeneration. And there won't be--until the National Eye Institute trial wraps. We'll see how NICE reacts then.