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Oct 15, 2007
 |  BioCentury  |  Strategy

Genentech's Avastin gambit

New distribution restrictions that Genentech Inc. plans to impose on Avastin bevacizumab will raise the cost of using the drug in the U.S. for off-label ophthalmic indications by up to 10-fold, but it will still be about four times cheaper than the company's Lucentis ranibizumab. Lucentis is approved to treat neovascular (wet) age-related macular degeneration, while Avastin has not been approved for any ophthalmic use.

In a move that DNA indicated is intended to steer physicians away from off-label use of Avastin and toward Lucentis, the company last week informed thousands of ophthalmologists that as of Nov. 30 it will prevent wholesalers from selling Avastin to compounding pharmacies.

Cost is the only reason to inject Avastin instead of Lucentis into a patient's eye, and compounding pharmacies have played a major role in slashing the cost of anti-angiogenesis therapy for a number of ocular indications.

The average wholesale price for a single-dose vial of Lucentis is $2,437, and the label calls for nine monthly injections.

The AWP of a vial of Avastin, which is approved for colorectal cancer and for metastatic non-small cell lung cancer (NSCLC), is $687. The vial, however, contains enough of the drug for 10 intravitreal injections.

Avastin is a monoclonal antibody against vascular endothelial growth factor (VEGF), while Lucentis is a MAb fragment that inhibits VEGF-A that DNA says was designed with features that are intended to optimize its intravitreal use: the molecule is about three times smaller than Avastin and has a shorter half-life.

Ophthalmologists do not have the equipment or training required to safely repackage a single Avastin vial into multiple sterile containers, which has allowed compounding pharmacies to provide the repackaging service.

Avastin will continue to be available to any physician and to hospital pharmacies. The cost of Avastin...

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