This is a pretty good example of a smart consultant using his blog to explain something complex. David Williams at the Health Business Blog got an on the record interview from Genentech about Avastin and Lucentis. If you know the background story skip this and go to the Interview with Genentech about Avastin distribution changes.

If you haven’t been following at home here’s a quick synopsis (and I’m in a rush and doing this from memory so I hope I get it right—please comment if you know more!).

Avastin is a biotech cancer drug intended for IV use. Then some
opthamologists found out randomly that it works well for macular
degeneration in the eye—a big cause of blindness among the elderly. The
key difference is of course that while it’s a very expensive drug in
the quantities needed for cancer tumors, in the eye you only need a
tiny amount. Sometime around then a little side-business in repackaging
Avantis in small quantities for opthamologists started up.

Once Genentech figured this out they repackaged the drug (and
changed it slightly) for macular degeneration and called it Lucentis.
Here’s the controversial piece; they priced the tiny dose at about the
same rate as a dose of Avastin.

This lead to some screaming in the media (and on THCB)
from patients who were now facing huge price increases (it’s a drug you
need over and over again), and effectively it’s gone from less than
$100 to more than $1,000 a dose. Then Genentech tried to stop the
repackaging by cutting off Avastin supplies to those who were doing it.

Now there are two sides to every story, or one an a half, but the
clear message going back to Genetech was that they were sticking it to
the consumer. A consumer, we note who was facing blindness.

Last week Genentech, upon pressure from the opthamologists seem to have abandoned that plan.

But it is all more complex than that. But hopefully now you’re ready for the Interview with Genentech about Avastin distribution changes.