A big difference

Tuesday, Sept. 2, 2008 | 2:10 a.m.

A federally approved drug for the most severe form of macular degeneration has been on the market since 2006.

It has been clinically proven to be effective, but another drug, developed in 2004 to treat colon cancer, is said to be its equal.

Many eye doctors say either drug is appropriate to treat the wet form of macular degeneration, which is becoming increasingly common among people over age 60.

If untreated, this disease can leave people with only peripheral vision. Monthly or bimonthly injections of either drug can, in many cases, lead to improvement.

Both drugs are manufactured by Genentech Inc., headquartered in San Francisco. The one specifically approved for macular degeneration, Lucentis, costs $2,000 per treatment. The one approved for colon cancer, Avastin, costs $60 per eye treatment.

Avastin is being prescribed by many eye doctors, and many more would use it if the drug’s label said it was federally approved for macular degeneration.

But as the Associated Press reported last week, Genentech is not seeking approval from the Food and Drug Administration for Avastin to be used in this way. Nor is the company helping to finance, or even cooperating with, a study of Avastin by the National Eye Institute.

Furthermore, Genentech is not saying whether it will act on the institute’s study, even if Avastin is clinically proven to be just as effective, the AP reported.

Individual consumers will not be the only ones paying far more than they would likely have to if Genentech continues to be uninterested in Avastin’s potential — but now off-label — benefit.

Medicare officials quoted by the AP say cases of the eye disease could grow by 50,000 or more a year. Covering just one year’s worth of new patients using Lucentis could cost the government’s insurance program for the elderly $1.2 billion. The price would be $60 million if Avastin were used.

Genentech says pricing for Lucentis reflects its development costs. We wish it would consider what the lower price for Avastin would reflect in volume sales worldwide — and public good will.