Eye doctor here. Avastin is currently used off-lable for eye conditions (most commonly wet AMD and macular edema in diabetes). It is only FDA approved for use in treatment of some colon and lung cancers. Generally speaking, even though it fits standard of care within the field of ophthalmology to use this drug, there are still some inherent risks in doing so for the practitioner, thusly, Lucentis is still preferred by some. Also, I've not encountered this (as MOST insurance companies would prefer practitioners to use the cheaper drug) but I've heard of difficulty with third party payer coverage/ reimbursement when using the off-lable drug.
Another thing to consider, as ajrw pointed out, they ARE NOT as the article mentions "the same drug." Some people respond more favorably to one versus the other. Commonly, the two will be used in succession on the same patient as though no double blind clinical trial has been done to confirm this; both drugs tend to exhibit a slight tachyphylaxis over time (diminished effect). Practitioners have found that when one drug starts becoming less effective, switching to the other VEGF inhibitor can show recapture of the previous level of therapeutic benefit.
I would advise all to take this article with a huge grain of salt. Most practitioners are not aiming to increase insurance costs (obviously, as generally speaking, the higher the bill, the harder it is to get the reimbursement.) Many are probably apprehensive to use an off-lable drug from a medical-legal stand point.
Note: I am not a surgeon. So some of this is slightly presumptive.
Eye doctor here. Avastin is currently used off-lable for eye conditions (most commonly wet AMD and macular edema in diabetes). It is only FDA approved for use in treatment of some colon and lung cancers. Generally speaking, even though it fits standard of care within the field of ophthalmology to use this drug, there are still some inherent risks in doing so for the practitioner, thusly, Lucentis is still preferred by some. Also, I've not encountered this (as MOST insurance companies would prefer practitioners to use the cheaper drug) but I've heard of difficulty with third party payer coverage/ reimbursement when using the off-lable drug.
Another thing to consider, as ajrw pointed out, they ARE NOT as the article mentions "the same drug." Some people respond more favorably to one versus the other. Commonly, the two will be used in succession on the same patient as though no double blind clinical trial has been done to confirm this; both drugs tend to exhibit a slight tachyphylaxis over time (diminished effect). Practitioners have found that when one drug starts becoming less effective, switching to the other VEGF inhibitor can show recapture of the previous level of therapeutic benefit.
I would advise all to take this article with a huge grain of salt. Most practitioners are not aiming to increase insurance costs (obviously, as generally speaking, the higher the bill, the harder it is to get the reimbursement.) Many are probably apprehensive to use an off-lable drug from a medical-legal stand point.
Note: I am not a surgeon. So some of this is slightly presumptive.
1: http://www.reddit.com/r/politics/comments/1sdxz6/an_effectiv...