CMS could save $18B by switching to Avastin from Lucentis

Medicare Part B could save $18 billion over 10 years if all patients were to receive Avastin bevacizumab instead of Lucentis ranibizumab to treat neovascular age-related macular degeneration (AMD) or diabetic macular edema (DME), according to an University of Michigan. The analysis, published in Health Affairs, estimates additional savings of $5 billion for patients and $6 billion in other health system expenses, bringing the total savings to $29 billion over 10 years. Lucentis, a humanized mAb fragment against VEGF-A, is approved in the U.S. for wet AMD and DME. Avastin, a humanized mAb against VEGF, is approved for various cancers but is used off label as a cheaper alternative to Lucentis for the ocular indications.

According to the analysis, both drugs have similar efficacy, but Lucentis costs Medicare about $2,023 per injection, while Avastin costs $55 per injection. According to a 2012 report from HHS's Office of Inspector General that was cited in the Michigan analysis, CMS spent about $2 billion on Lucentis in 2010, or about one-sixth of the $12 billion spent by the agency on drugs that year under Part B. ...