Study: Subbing Avastin for Lucentis could save U.S. $3B on eye treatment

To save money, doctors have long repurposed Roche's ($RHHBY) Avastin for the eye in place of using the company's pricier Lucentis. Now, a study says the U.S. could save almost $3 billion a year if Medicare patients always received the cheaper drug--a prospect Roche isn't so keen on.

According to a study in the journal Health Affairs, treatments for eye diseases claim about one-sixth of the Medicare Part B budget, Bloomberg reports. But it doesn't necessarily have to be that way. While only the $2,000-plus-per-dose Lucentis has the FDA's approval to treat wet age-related macular degeneration and diabetic macular edema, Avastin, which can be prescribed off-label, works the same, studies have shown--and costs 40 times less.

"These are big dollars that could be saved for Medicare and patients," lead study author David Hutton told the news service.

But big dollars saved for Medicare are big dollars lost for Roche, which has long insisted Lucentis is a better option for eye use. The FDA, too, has expressed safety concerns over using Avastin in the eye, warning that repackaging the drug in small doses might result in serious infections that could lead to blindness.

"We specifically designed Lucentis for use in the eye and to clear quickly from the bloodstream after leaving the eye to potentially minimize side effects," Allison Neves, a spokeswoman for Roche's Genentech unit, told Bloomberg. "The two medicines were designed for different purposes and, we believe, may have different systemic and ocular safety profiles when used in the eye."

Roche needs to hang on to its Lucentis sales if it wants to compete with Eylea, the high-flying new market entrant that's been generating booming sales for maker Regeneron ($REGN) and its partner, Bayer.

But officials in Europe claim Roche and Lucentis marketing partner Novartis ($NVS) may have taken things too far. Italian antitrust authorities in Italy fined the pair $251 million in damages earlier this year on charges that they colluded to protect Lucentis revenues, forming a "cartel" to restrict sales of Avastin to eye doctors. Now, the country is seeking an additional $1.6 billion, and authorities from France and the EU are looking into things, too.

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