Genentech enrages vitreoretinal specialists

Implications: -Retinal community unites against Genentech -both the American Association of Ophthalmology and the American Society of Retinal Specialists have condemned Genentech's actions -this represents profit-driven pharma at their worst -very poor decision by Genentech...not only to galvanize the profession they should be seeking to court against them...but also to put at risk hundreds of thousands of patients -myriad very interesting legal points are raised

Analysis: Genentech has managed to enrage vitreoretinal specialists...by announcing...in October '07...their plan to stop supplying Avastin to compounding pharmacies....

The issue at hand is that the off-label use of Avastin by retinal specialists...is cutting in severely to their potential profits from Lucentis...Lucentis is currently selling for approximately $1500 per dose...whereas the off-label use of Avastin costs approximately $50 per dose. Avastin has however become...worldwide...the standard of care for patients with not only wet ARMD....but also various other retinal vascular entitities...most notably many aspects of diabetic retinopathy and retinal vascular occlusions.

There is no conclusive evidence that Lucentis is superior or safer...and in fact...in evidence released at this past weekends American Society of Retinal Specialists meeting in Palm Desert, California...it seems that likely Avastin is not only more efficacious...but longer lasting...thus needing less frequent injections.

In addition to potentially denying thousands of patients with wet ARMD therapy (by trying to force what is a prohibitively expensive treatment for many) what is also overlooked is that Avastin is currently also the worldwide standard of care for many ocular conditions not associated with AMD...and thus not appropriate for Lucentis...such as diabetic maculopathy....proliferative diabetic retinopathy, rubeosis, central vein occlusions...etc etc.

The furor created by Genentech's announcement has caused them to retract their position...the "embargo" is now scheduled to commence Jan 1'08...pending further discussions.

Should the embargo actually happen...legal challenges will undoubtedly follow...both by vitreoretinal specialists and also disenfranchised...and blinded patients....

Very interesting times ahead.

Fasten your seat belts!!