Avastin, Lucentis Equally Effective for Eye Disease Despite Cost Disparity

New research suggests that the cancer drug Avastin is equally effective at treating age-related macular degeneration (AMD) as the medication Lucentis, which is specifically approved for treatment of the eye condition and costs 40 times as much. 

In a study published by the American Academy of Ophthalmology (PDF), researchers from the Center for Preventative Ophthalmology and Biostatistics at the Perelman School of Medicine in the University of Pennsylvania compared the effectiveness of two drugs.

While Lucentis is approved by the FDA for treatment of age-related macular degeneration (AMD), it cost about $2,000 per dose. The cancer drug Avastin is commonly used “off-label” to treat the condition, as it only costs about $50 per dose.

Although drug companies are not allowed to advertise or market their products for any uses that have not specifically been approved by the FDA, doctors are able to prescribe almost any drug they see fit for the treatment of their patients.

The researchers conducted a two-year study on the two drugs involving more than 1,100 participants who suffered from AMD. They found that there was little difference in outcomes between those treated with Lucentis and those treated with Avastin. However, Avastin did have a slight increase in the risk of serious adverse events than Lucentis. The researchers said the interpretation of that increased risk is uncertain.

The study comes as Novartis, the makers of Lucentis, are pursuing a lawsuit in Britain to force state-run hospitals to prescribe Lucentis instead of Avastin. The company argues that Lucentis is the only drug approved by the government to treat AMD, so state-run facilities should not be able to prescribe Avastin off-label.

A similar study was conducted about a year ago, sponsored by the National Eye Institute, which also found that the drugs carried a comparable effectiveness.

In another study conducted three years ago, researchers indicated that side effects of Avastin may cause severe eye inflammation when the medication is used to treat AMD in some patients.

AMD affects more than 2 million Americans over the age of 50 and is the leading cause of blindness in the United States, according to the American Academy of Ophthalmology. That number is expected to double by 2020 as members of the “baby boomer” generation continue to age.

Avastin (bevacizumab) was approved by the FDA in 2004 for treatment of non-small cell lung cancer and colorectal cancer when combined with chemotherapy. It was developed by Genentech, which was later acquired by Roche. The drug works by restricting blood flow to tumors; starving them. Avastin sales reached nearly $6 billion in 2009.

Avastin received approval to treat breast cancer in February 2008, but had that approval taken away after the FDA determined it was not helping breast cancer patients and exposing them to potential Avastin health risks, which may include severe high blood pressure, heart attacks, heart failure, bleeding and hemorrhaging and the development of perforations in the nose, stomach and intestines.