Big Pharma Has an Ethical Issue with Costs of 2 AMD Drugs

Big Pharma has, along with the oil industry, a bad reputation among major businesses.   As a former employee, I’m unhappy to report a further example where Big Pharma is its own worst enemy.  The company concerned must think a foolish marketing decision won’t be picked up by alert pharma-watchers.  This story comes from Medical News Today, a reliable source. 

 I’ve written before about two interesting drugs used in the treatment of age-related macular degeneration (AMD) – Lucentis® and Avastin®.  Both are made and sold by Genentech, a subsidiary of Hoffman-La Roche.  Although both are biologically and clinically similar, Lucentis costs up to 100 times as much as Aventis.  Although we’ve had evidence of equal effectiveness from a small trial done at Boston Veterans Affairs Hospital, the NIH is conducting a larger comparative trial that will, most likely, replicate the findings of the first study.

In the meantime, Genentech has been offering a rebate program for the top prescribers of Lucentis, but not for Avastin.  To most people’s minds, this smacks of a kick-back.  While pricing incentives in the form of rebates are common in most commercial enterprises, if they are liable to affect a physician’s decision regarding patient care they present ethical, if not legal, problems.  In this case, the desired effect is to have the physician prescribe the more expensive of two almost identical drugs, with consequently greater profits for Genetech and higher costs for the patient and/or Medicare.  Altogether, a foolish move that compounds the already-controversial price differential.