Tuesday, May 17, 2011

The Value of Comparison

The recently released CATT trial showed that Lucentis and  Avastin were essentially equivalent in treating wet ARMD. The fact of the matter is that retina specialists using avastin have saved Medicare and insurance companies millions upon millions of dollars. In response, ironically, Medicare decreased the already minimal reimbursement for the injection component of administering the medication by doctors. One could have further argued that Medicare should indeed have put into place an incentive program to reward physicians  that saved Medicare so much money by using avastin!!
Uvealblues

Before you take a drug or undergo a medical procedure, wouldn’t you want to be sure it is the most effective and, if possible, the least costly available?
That is the idea behind so-called comparative effective research that is part of the health care reform law. Unfortunately, in the effort to win Republican support (support that never materialized), the bill’s sponsors agreed to bar Medicare from using comparative studies to determine which treatments to pay for. Critics charged it would mean more bureaucratic interference and a step toward socialized medicine.
The shortsightedness of that thinking was made clear last month when results were released of a government-sponsored study comparing two drug treatments for macular degeneration, which is the leading cause of vision loss and blindness in older Americans.
Both drugs are made by Genentech. Even so, there is a vast difference in their cost and, until now, uncertainty about their relative effectiveness.
(..)
Clinical trials sponsored by Genentech showed that Lucentis is highly effective in preserving and improving vision. The cost per monthly dose, however, was set by the company at $2,000. Enterprising eye doctors quickly realized they could get similar results by using Avastin in small doses. Avastin can cost thousands of dollars a month for the quantities used to treat cancer, but the doses suitable for injection into the eye cost about $50 a month.
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