Roche offers money-back deal on Avastin in Germany

When pricing gets tough, it's time to get creative. Facing unprecedented pressures in Germany, Roche is offering a pay-for-performance deal on its cancer drug Avastin. If patients don't respond, hospitals and public insurers that sign up for the deal will get their money back. The offer is valid for initial treatment of advanced cases of colorectal, breast, lung and kidney cancers.

The offer, while unusual, isn't unique. Drugmakers have used similar patient-access schemes to persuade U.K. gatekeepers to accept pricier treatments. They're seen as a way for pharma companies to share the risk of using expensive treatments, especially pricey meds that are known to work only in a minority of patients.

Avastin delivers spectacular results in some patients, but in others, the results are less impressive, as Reuters points out. In breast cancer, the data is so inconclusive, the FDA has proposed revoking its indication for that use. However, European regulators recently affirmed Avastin's breast cancer use by approving it in combination with an additional chemo drug. Oncologists and patient advocates are split on the issue.

Roche's pricing offer in Germany isn't without its detractors. The German Medical Association's drug commission chief Wolf-Dieter Ludwig said the arrangement could induce doctors to use Avastin too early and too fast. In some indications, Avastin has questionable therapeutic benefit, Ludwig said, and patients can suffer significant side effects. Roche said the offer can help Germany control its healthcare costs. "We stand by the contract," spokesman Hans-Ulrich Jelitto told the Süddeutsche Zeitung.

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