After comparing the costs of Genentech Inc.'s Avastin bevacizumab and Lucentis ranibizumab to treat wet AMD, the HHS inspector general has called for giving Medicare more power to control drug spending. It is the latest in a long history of calls for CMS to deny coverage of one drug in favor of a less expensive alternative. But given its current makeup, Congress looks unlikely to make the legal change required for the agency to implement such a policy.

Last week's Office of Inspector General (OIG) report documented the difference in acquisition costs for Lucentis and Avastin for wet age-related macular degeneration. The report said using Avastin instead of Lucentis for two years during 2008 and 2009 would have saved Medicare Part B $1.1 billion, while beneficiaries would have saved $275 million in co-payments.