France aims to save big bucks by subbing unapproved Avastin for eye drug Lucentis

In June, the Italian government said it would pay for Roche's ($RHBBY) cancer drug Avastin to be used to treat a blinding eye disease, in place of the company's far more expensive eye drug Lucentis. Now, France is following Italy's lead.

The French legislature has introduced an amendment to its social security budget bill that would green-light the use of Avastin in age-related macular degeneration (AMD), even though the drug is not approved for that use. Lawmakers will vote on the measure next week. The move would affect both Roche and its Lucentis marketing partner in Europe, Novartis ($NVS).

And it's backed up by some compelling economic arguments. Gerard Bapt, one of France's socialist legislators, estimates that Avastin is 30 times less expensive than Lucentis in that country. A positive vote on the measure could save France at least €200 million ($273 million) a year, Bapt estimates, according to Reuters.

Roche and Novartis think they have compelling arguments, too--and they're both speaking out loudly against the initiative. Lucentis has the same mechanism of action as Avastin does--they both inhibit the formation of harmful blood vessels--but the companies have long held that it's not safe to use Avastin in the eye.

"We do not see how reimbursing off-label use for cost reasons in France is justified in the interest of public health, where there are licensed alternatives," Novartis said in a statement emailed to Reuters. Roche echoed with a statement blasting France for compromising patient safety and violating EU laws. Lucentis is a top seller for both companies, bringing in $2.4 billion in sales last year for Novartis and $1.9 billion for Roche.

Using Avastin off-label to treat AMD may be illegal, but France isn't the only country that's finding the economics hard to ignore. A recent U.S. study estimated that Medicare would save $3 billion a year if doctors abandoned the $2,000-per-dose Lucentis and instead used Avastin, which costs 40 times less than the eye drug. Treatments for eye diseases currently claim an estimated one-sixth of the entire Medicare Part B budget.

To complicate matters for Roche and Novartis, the companies face allegations in Europe that they colluded to protect sales of Lucentis. Italian antitrust regulators are seeking €1.2 billion ($1.6 billion) in damages from the companies, and France and the EU have embarked on investigations of their own.

- here's the Reuters story

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