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Infection Risk Prompts VA to Drop Avastin as Eye Treatment

Sep 22, 2011 | Parker Waichman LLP

The Department of Veterans Affairs (VA)  will no longer use Avastin to treat age-related,  wet macular degeneration until  it finishes an investigation into blinding eye infections linked to the  treatment.  Doctors with the VA are being urged to use Lucentis, another  - and more expensive - drug made by Genentech that is actually approved for this use.

According to an alert issued by the  U.S. Food & Drug Administration (FDA) last month, 12 people in Miami, Florida, were apparently infected with Streptococcus oralis after receiving Avastin eye injections.  Clusters of  bacterial infections were also reported in connection to Avastin eye treatments administered at VA facilities in Tennessee and California.

"The Department of Veterans Affairs (VA) has ceased ophthalmologic use of Avastin pending the results of an ongoing investigation and will advise its physicians to consider alternate therapies," the VA said in a statement.

"Once the investigation is complete, VA will reassess how Avastin and similar therapies may be made available for ophthalmologic use and will issue further guidance, " it continued.

Avastin is approved to treat certain cancers, and Avastin injection for macular degeneration is an off-label use.  In order to obtain the proper dosage for this type of treatment, compounding pharmacies must repackage Avastin into smaller vials.   This can make it possible for the medication to become tainted with bacteria.  Genentech, the maker of both Avastin and Lucentis, has cautioned that doctors not use Avastin to treat macular degeneration because of this potential.   But  doctors still use Avastin in this manner because it is far less expensive Lucentis.  Avastin costs only $50 per dose, with Lucentis coming in at $2,000.  Unfortunately, it is becoming more apparent that the cost savings offered by Avastin may not be worth the risk.

"The fact that the VA made this decision shows that the risk of substituting Avastin for Lucentis might be a little greater than we thought before,"  Morningstar analyst Lauren Migliore told Reuters.

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