The NEJM, in an article called The Price of Sight — Ranibizumab, Bevacizumab, and the Treatment of Macular Degeneration catches up with a THCB contributor from 4 months ago. The issue is that Genentech has a new and to the unwashed un-sophisticates (i.e. me and apparently most opthamologitsts) seemingly identical drug (Lucentis) for which it wants to charge 20 times the amount of Avastin, when Avastin works fine or better. Although of course Avastin hasn’t had a clinical trial for exactly that indication, and Genentech is apparently restricting supplies of Avastin in order to force you and me (the taxpayer) to cough up for Lucentis instead (and for the poor patient who must pay 20% of a much bigger number than if they’d paid out of pocket for Avastin.

Genetech does appear to be gilding the lilly here. I mean seriously who ever heard about a drug company complaining about un-promoted off-label use of its product? Unless of course, the off-label use cuts into the sales of a much more expensive version of the same thing!

On the other hand if someone can explain if there’s a justifiable difference, you know where the comments button is.