Aggressive lobbying keeps seniors on Lucentis, prevents Medicare savings, USA TODAY article states

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Lobbying efforts have ensured that long-term care residents and other seniors are commonly prescribed the expensive drug Lucentis, even though the less costly drug Avastin has proven equally effective, suggested a USA TODAY article published Thursday. Lucentis has become the No. 1 drug reimbursed by Medicare, which paid out more than $956 million for it in 2012, according to the newspaper's analysis of recently released Medicare data

Lucentis and Avastin both are made by Genentech, a subsidiary of pharmaceutical giant Roche. Lucentis is approved to treat the common eye condition in seniors known as age-related macular degeneration; Avastin is FDA-approved only as a cancer drug, but a federal study showed it is as effective as Lucentis in treating macular degeneration, USA TODAY noted.

"Lucentis and Avastin were designed for different purposes and may have different safety profiles when used in the eye," Genentech spokeswoman Charlotte Arnold told USA TODAY. (Avastin also has been linked to a higher likelihood of blindness than Lucentis.)

While Arnold argues that limiting Avastin use is a matter of “patient safety,” the USA TODAY article presented it is a possible example of how big pharmaceutical companies flex their lobbying muscle to protect their bottom lines.

Roche/Genentech spent $30 million to lobby the federal government between 2009 and 2013, according to the newspaper's examination of Center for Responsive Politics data and Medicare information that just became publicly available for the first time. The reporters could not say how much Genentech spent specifically on Lucentis-related initiatives, but they highlighted the company's financial stake in maintaining the status quo: Physicians administered Lucentis more than 3 million times in 2012, compared with 600,000 administrations of Avastin, according to the article. Each Lucentis injection costs roughly $2,000, compared with $50 for Avastin.

Genentech's spending is not remarkable in the world of big pharma, the USA TODAY reporters pointed out. Pharmaceutical companies spent $225 million last year alone.

Meanwhile, laws and regulations have remained largely favorable to pharma companies despite opportunities for substantial savings to Medicare, the article stated. For example, if Part B reimbursement rates were based on the least costly drug available for a particular condition — rather than average cost — Medicare could have saved $122 million between 2010 and 2012, according to the Medicare Payment Advisory Commission.

The rise of Lucentis and Avastin has reduced the number of blindness-related nursing home admissions, according to findings recently published in JAMA Ophthalmology.

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