As pharma-watchers discuss Avastin's strong showing in a head-to-head eye treatment trial against Lucentis, Genentech is already campaigning against the study result to protect its pricier drug. Now owned by Roche, Genentech makes both Avastin and Lucentis, but Avastin is used off-label to treat macular degeneration, while Lucentis is expressly approved for that use.
As the Wall Street Journal reports, the company has already met with Senate staffers to highlight perceived flaws of the new study. And it has enlisted Johns Hopkins researcher Emily Gower, who led a company-funded trial comparing the two drugs. Among other questions the company has raised is whether the National Eye Institute's 1,200-patient randomized, controlled trial was large enough to prove that Avastin is safe for eye use.
Citing its own analysis of existing data on 78,000 Medicare patients, Genentech said those who used Avastin as an eye treatment were more likely to die and much more likely to experience a hemorrhagic stroke than Lucentis patients were. The study tried to correct for other factors that might have contributed to that greater risk--smoking, for example, or underlying health problems--but the New York Times reports that experts are already debating whether that correction was adequate.
The data from both studies are set to be released at the ophthalmology conference early next week, so we can expect plenty of slicing and dicing to come. Obviously, Genentech plans to do everything it can to support Lucentis for eye use. The company has big money at stake; Lucentis runs about $2,000 per injection, versus $50 for an eye-sized dose of Avastin.
As the NYT points out, Medicare paid for 480,000 Avastin eye-treatment injections in 2008, compared with 337,000 injections of Lucentis. But the government-funded program spent only $20 million for the Avastin treatments, versus $537 million for Lucentis.