Novartis ponders Lucentis price cut in UK
Novartis could cut the price of its eye drug Lucentis in the UK to head off moves to switch patients to off-label Avastin.
The company said yesterday that it was in discussions with the Department of Health and NICE “about the cost effectiveness of Lucentis across all of its indications”.
This suggests the company is considering a price cut for the wet AMD treatment in the UK, as it did in Switzerland last year.
Health systems and doctors around the world are using Roche/Genentech’s Avastin (bevacizumab) off-label in place of Novartis’ Lucentis (ranibizumab) because of the huge cost saving to be made. This is likely to increase, following the publication of several clincial studies showing the drugs are equally safe and effective.
Avastin costs only £60 per injection, whereas Lucentis costs around £750.
Because Avastin is not licensed for this use, the US and UK governments have funded trials to establish the safety and efficacy of the drug compared to the licensed Lucentis.
Pressure on Novartis increased on Sunday with the publication of a new UK study which showed Avastin to be just as effective in treating wet AMD as Lucentis.
The IVAN study, which has been funded by the UK government, compared improvements in sight in patients with wet age-related macular oedema given either Lucentis or Avastin.
The one-year study involved 610 patients in 23 hospitals across the UK, and showed that patients using Avastin had similar results to those using Lucentis.
Professor Usha Chakravarthy of Queen’s University in Belfast, who led the clinical trial, told the BBC: “Regardless of which drug they received, the average person improved by approximately one line [on an eye chart].
“And when it comes to comparing the two drugs, the difference was extremely small - less than two letters on the eye chart.”
The IVAN study comes hot on the heels of the CATT study, a similar head-to-head between the drugs, which also concluded that Avastin and Lucentis produced similar improvements, with a similar safety profile.
Novartis pointed out that side effects, some of them serious, were higher in the Avastin arm of the study, but healthcare payers look unlikely to be moved by the relatively small concern set against the price difference.
The stakes are high for Novartis UK, as the NHS spent £130 million on Lucentis last year.
The IVAN study concludes that by switching to Avastin, the NHS could save around £85 million a year. This would take a massive bite out of Novartis’ UK revenues, which are already being undercut by off-label prescribing of Avastin.
Lucentis has been recommended by NICE as a treatment for wet AMD, but the watchdog is currently not endorsing its use in diabetic macular oedema or retinal vein occlusion.
By cutting its price Novartis could also sway NICE into recommending the drug for its other two licences.
Avastin is not licensed for this indication, but many ophthalmologists have been using it off-label for a number of years, as it is cheaper than Lucentis.