Saturday, December 22, 2007

Genentech offers reassurance

Despite earlier concerns, most physicians should have no trouble continuing to obtain a relatively inexpensive Genentech drug to treat the eye disorder macular degeneration, executives at the South San Francisco company and two doctors' groups have announced.

Genentech had dismayed some doctors in October when it informed them it no longer would allow compounding pharmacies, which specialize in mixing drugs, to obtain Genentech's Avastin from drug wholesalers as of Nov. 30. Many doctors had relied on those pharmacies to make the proper dose of Avastin for patients suffering from the eye disorder.

Avastin is only approved for sale as a cancer treatment. But doctors are allowed to use it for macular degeneration and many do so because it seems effective for that purpose and is far cheaper than Genentech's Lucentis, which is approved for the eye disorder. A dose of Lucentis costs $1,950 vs. about $40 for a comparable dose of Avastin.

Genentech noted in October that doctors still could obtain Avastin directly from wholesalers and it later extended the date to Jan. 1 when it would stop pharmacies from purchasing the drug. But Dr. H. Dunbar Hoskins Jr., executive vice president of the American Academy of Ophthalmology, said it remained unclear whether the wholesalers would deliver Avastin to compounding pharmacies at the doctors' behest.

After his group and the American Society of Retinal Specialists conferred with Genentech, however, Hoskins said it has been determined that doctors generally should have no problem getting the drug sent to the pharmacies.

"Really, nothing has changed" about Genentech's position, added company spokeswoman Krysta Pellegrino, except that doctors have been reassured they can still obtain Avastin from the pharmacies next year.

Genentech executives have said the decision limiting Avastin sales stemmed largely from concerns raised by the U.S. Food and Drug Administration that the drug may not be safe for treating macular degeneration, particularly when it is repackaged by pharmacies. They also have denied their action was driven by a desire to sell more of the expensive Lucentis.

Nonetheless, the company's action prompted an inquiry by Sen. Herb Kohl, D-Wis., chairman of Congress' Special Committee on Aging. Noting that most of those with the eye disorder are on Medicare, Kohl estimated that if doctors were forced to stop prescribing Avastin and switch to Lucentis, it could cost the federal insurance program up to $3 billion more each year.

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