Occassionally I get actual patients writing into me at THCB and sometimes it’s worth letting their experience with the system tell a story about how the opaque world of drug and health services pricing comes home to ground level. This is a verbatim email from a 70 year old patient Pat Awash:
Friday, June 9, 2006 I was facing imminent blindness in one eye and poor vision in the other. Beginning Saturday a miracle began to unfold after an initial injection in my eye of Avastin. Avastin is used to treat mestasticized colon cancer and someone deduced that it might, just might be effective for Age-Related Macular Degeneration, the leading cause of blindness and vision impairment among the elderly.
Due to an undetermined cause, leaking fluid had formed a large blister behind my retina causing four changes in my eye-glass
prescription between February 24, 1906 and late May, 2006, the last of which
did not hold for four days. I was frightened to say the least. Only one day after the injection I experienced a 70% vision improvement. This improvement continues each day and I am using a three-year-old prescription.
I am writing in objection to the current policy of the FDA in regard to Avastin. It is an off-label use but the cost is minimal, only $60.00 when provided at cost as my physician does. The same drug company that
makes Avastin has developed Lucentis which has a slightly different molecular
structure than Avastin but is basically an analog. Only thing is, Lucentis will cost an expected $1,500.00 per dose. They claim a reported $400 million research cost but I’m wondering what is included in that amount.
I hope you get the picture. The manufacturer of Lucentis has changed the drug to the degree that it can be classified as a new drug. Whereas Avastin is expensive when used as a cancer drug it is very inexpensive for eye treatments because the dose is so small, and some would say Lucentis is not as effective. Once approved, Lucentis will be covered by
Medicare, a windfall for the manufacturer and huge cost to the public considering a rapidly aging population. Gentech could have done the trial on Avastin.
Everything would be ok except Genentech will no longer make Avastin available except to those who exclusively treat cancer patients.
No off-label applications and no choice for patients. Thankfully, my physician bought a substantial (several month’s) supply prior to the June 1, 2006 cut-off date.
I find this insane and I think you will too. I am sick and tired of experts saying how much trouble Medicare is in when this kind of shenanigan is going on.
Pat Ahwash (a 70-year-old senior citizen)