Via: Washington Post:
The two drugs have been declared equivalently miraculous. Tested
side by side in six major trials, both prevent blindness in a common
old-age affliction. Biologically, they are cousins. They’re even made by
the same company.
But one holds a clear price advantage.
Avastin costs about $50 per injection.
Lucentis costs about $2,000 per injection.
Doctors choose the more expensive drug more than half a million times
every year, a choice that costs the Medicare program, the largest
single customer, an extra $1 billion or more annually.
Spending that much may make little sense for a country burdened by
ever-rising health bills, but as is often the case in American health
care, there is a certain economic logic: Doctors and drugmakers profit when more-costly treatments are adopted.
Genentech, a division of the Roche Group, makes both products but
reaps far more profit when it sells the more expensive drug. Although
Lucentis is about 40 times as expensive as Avastin to buy, the cost of
producing the two drugs is similar, according to scientists familiar
with the drugs and the industry.
Doctors, meanwhile, may benefit when they choose the more expensive
drug. Under Medicare repayment rules for drugs given by physicians, they
are reimbursed for the average price of the drug plus 6 percent. That means a drug with a higher price may be easier to sell to doctors than a cheaper one. In addition, Genentech offers rebates to doctors who use large volumes of the more expensive drug.
“Genentech continues to maintain that Lucentis is the most
appropriate medicine,” the company said in a statement, adding that it
costs “significantly” more to make and is tailored for use in the eye.
The drug “has made an immense impact.”
Many ophthalmologists, however, are skeptical that it provides any added value over the cheaper alternative.
“Lucentis is Avastin — it’s the same damn molecule with a
few cosmetic changes,” said J. Gregory Rosenthal, a Toledo
ophthalmologist who, outraged by the price, co-founded a group called
Physicians for Clinical Responsibility to protest its use. “Yet
Americans are paying a billion dollars every year for no good reason —
unless you count making Genentech rich.”
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