Medicare gives eye docs their way on Avastin

Once again, eye doctors have successfully lobbied to keep their Avastin. Medicare will abandon its new, lower reimbursement level for the cancer drug when used by eye doctors to treat wet macular degeneration, the Wall Street Journal Health Blog reports. The government program had cut prices for the Genentech drug so significantly that ophthalmologists said they'd lost money on the injections--and they'd have to switch to Genentech's much pricier, purpose-built drug Lucentis.

There's been an ongoing tug-of-war over ophthalmic use of Avastin. That's because it's not FDA-approved for eye use, but for cancer treatment. Genentech developed Lucentis to treat WMD--but Lucentis is so similar to Avastin, and so much more expensive, that docs continued to use Avastin off label.

Genentech tried to curtail distribution of Avastin to the compounding pharmacists who repackage it for eye use. But ophthalmologists raised Cain, and the company backed off a bit. Recently, Medicare decided to cut Avastin reimbursement from $50 a dose or so to about $7 a dose, which eye docs said was below their cost. They said the government would spend millions unnecessarily on Lucentis, which costs some $2,000 per dose. Apparently, Medicare listened. The reimbursement goes back to $50 January 1.

- see the Health Blog story