NICE blow highlights ongoing Lucentis-Avastin debate

The U.K.'s cost-effectiveness watchdog nixed Roche's Lucentis eye drug as a treatment for diabetic eye disease, at a time when debate over the pricey drug's use is escalating. As Dow Jones reports, the National Institute for Health and Clinical Excellence decided against approving Lucentis for diabetic macular edema, saying it did not represent "good value for money."

NICE affirmed that Lucentis is effective at treating the eye condition, but said that wasn't enough to justify using it given its high price tag. "Unfortunately, in this case," said NICE chief Andrew Dillon, "the committee agreed that the evidence didn't support a positive recommendation." Novartis, which markets Lucentis outside the U.S., says it will try sway NICE over the next few weeks.

One problem is the fact that Lucentis has a competitor--its own company's cancer drug Avastin, which, while expensive for its FDA-approved use, is quite reasonable at the small doses required for off-label eye-care treatment. The company has continued to push Lucentis, while making some efforts to limit use of Avastin for wet macular degeneration and studying the pricier Lucentis for other uses, such as diabetic macular edema.

The Avastin vs. Lucentis debate prompted the National Institutes of Health to mount its own head-to-head study of the two drugs for macular degeneration. As Dow Jones points out, the results of that study are just weeks away. If Avastin proves equally effective, then it may get FDA approval for the eye use, an indication Roche's Genentech unit has pointedly refused to seek on its own. No wonder, given the R&D effort and expense required to win approval for Lucentis--and its current $1.6 billion in sales.

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