Friday, October 07, 2011

Avastin/Lucentis Update 51: And, the Dam Breaks!

After reporting on the news out of England earlier this week (Update 50), I have been waiting for the “other shoe” to drop – and it just has, as reported by InPharm this morning (as tweeted by RetinaToday). Here is the story found on the InPharm website:

Novartis cuts Lucentis price amid growing pressure

Published on 10/07/11 at 10:15am

Novartis has been forced to cut the Swiss price of its eye drug Lucentis by 30% after sharp negotiations with the government. The deal was negotiated by Switzerland's Health Minister Didier Burkhalter and could save the country hundreds of millions of francs over the next five years, according to local newspaper La Matin.

Lucentis (ranibizumab) is licensed in Europe to treat the eye disease wet age-related macular oedema, a leading cause of blindness in the over fifties. But ophthalmologists have been opting to treat patients with Roche's cancer drug Avastin (bevacizumab), which - though not licensed for wet AMD - is chemically similar to Lucentis and around 20 times cheaper.

Roche co-markets Lucentis with Novartis in the US, and has no plans to seek a new licence for Avastin for the eye disease because it would be undercutting its own drug. According to La Matin Burkhalter knew this, but still pressured Roche to conduct new trials for Avastin in wet AMD in order to persuade Novartis - whose head office is in Switzerland - to negotiate over the price of Lucentis.

The price cut could go even deeper. A ministry spokesman for the health ministry told La Matin: "We have been successful on this last point with a drop of 30%," but added that if nationwide sales of the drug exceed 108 million francs, then the price will have to drop again. This could have repercussions across other countries as Switzerland acts as a reference for many other markets, although many countries are already investigating using Avastin off-label without Roche's consent.

This is happening in the US where nationally-funded trials are ongoing to see if Avastin is as safe and effective as Lucentis in treating wet AMD. The main impetus is cost as analysts are projecting that switching treatments could save the US $1 billion over the next two years.

Both Roche and Novartis have fought against the use of Avastin in wet AMD, saying that patients are at risk of infections and other side effects from using Avastin off-label because it has not been studied for safety in wet AMD patients. But the Swiss price cut represents a realization that Lucentis must still compete with Avastin, even if it doesn't want to. This is especially true now that austerity measures start to take aim at healthcare budgets, with drugs like Lucentis representing an easy target for swift savings.

Ben Adams


At 2:54 AM, Anonymous David Y said...

I think this is just the start of the fall for Lucentis
VEGF Trap Eye is not too far away and proven to be being just as effective at 2 monthly treatments as Lucentis is at monthly injections.
Also the existing risk of endopthalmitis with Lucentis -recently shown to be significantly higher than cataract surgery will be halved.
Will anyone use Lucentis or Avastin if and when VEGF Trap Eye is available?

At 3:59 PM, Blogger Matt said...


Would love to hear your thoughts on the VA's decision to allow Avastin again...but only for one dose per manufacturer's vial. What a circus!


At 4:06 PM, Blogger Irv Arons said...

Matt, I agree with you -- they obviously don't know what they are doing!

Why would anyone follow that kind of advice? Don't they trust their pharmacists to do the right thing?


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