Avastin v. Lucentis: An Early Test Case For Medicare ACOs

Medicare costs for covering Genentech's Lucentis for wet age-related macular degeneration will get heightened scrutiny now that a widely anticipated National Institutes of Health trial has confirmed that much-less-expensive treatment with the company's Avastin is as effective. Based on 2008 claims data, Medicare is spending about $500 million more on Lucentis than Avastin for treatment of wet AMD.

Medicare costs for covering Roche's Genentech Inc.'s Lucentis (ranibizumab) for wet age-related macular degeneration will get heightened scrutiny now that a widely anticipated National Institutes of Health trial has confirmed that much-less-expensive treatment with the company's Avastin (bevacizumab) is as effective. Based on 2008 claims data, Medicare is spending about $500 million more on Lucentis than Avastin (bevacizumab) for treatment of wet AMD.

Specifically, Medicare spent $537 million for Lucentis in 2008 versus $20.3 million for Avastin, according to a claims review by...

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