Dept of Pure Evil: Genentech says “no substitutions”

Genentech makes an eye drug called Lucentis. It’s expensive: $2000/month. They also make a cancer drug called Avastin. It’s inexpensive: $40/month.

The two drugs are chemically very similar. So similar, in fact, that compounding pharmacies are repackaging Avastin and doctors are prescribing it for the eye problem.

Genentech doesn’t like this. They want the money for Lucentis. So, they’re stopping shipment of Avastin to all the pharmacies and sending it only to hospital pharmacies or directly to doctors. Furthermore, they’re refusing participate in the NIH study to confirm or reject the similar usefulness of the two drugs, and not even providing drugs at cost to the study as is customary.

Result? $1-$3 billion more a year of taxpayer money into Medicare, because almost all the patients involved are over 65. I think it’s great how the drug companies selflessly do research and development to keep us all healt… yeah.

Wall St. Journal article below.

Genentech to Limit Avastin Availability
Use of Cancer Treatment
For Eye Ailment Hurts
Sales of Targeted Drug
By JACOB GOLDSTEIN and MARILYN CHASE
October 12, 2007; Page B6

Genentech Inc. said it will stop making its cancer drug Avastin available to certain pharmacies in a bid to curb its use in treating eye disease — which has cut into sales of the company’s high-priced eye drug.

Although regulators haven’t authorized Avastin’s use against eye disease, it is chemically similar to Lucentis, which was approved last year to treat wet macular degeneration, a leading cause of blindness in the elderly. Compounding pharmacies, which are licensed to mix and repackage drugs, put Avastin into syringes that contain a once-monthly dose of the drug for use in the eye and cost about $40. A once-monthly dose of Lucentis costs about $2,000.

In the first six months of this year, U.S. sales of Avastin were $1.1 billion, and Lucentis sales were $420 million.

Medicare, which offers health coverage for the elderly and disabled and is a big purchaser of the two drugs, has said curbing Avastin could cost taxpayers $1 billion to $3 billion a year. Using a cheaper drug not only would preserve Medicare funds, but would trim beneficiaries’ exposure to high co-payments, program administrators say.

The question of the drugs’ equivalence may be decided in a study sponsored by the National Institutes of Health. Genentech has refused to support the head-to-head study, nor to provide the two drugs at cost, reasoning it already has invested seven years of research and development in validating Lucentis as safe and effective.

Battle lines over usage pit retinal specialists — many of whom have opted to prescribe Avastin — against the company and its backers, who say recovering profits is necessary to preserve the U.S. edge in health-care innovation.

In a letter explaining its decision, Genentech, the world’s second-largest biotechnology company after Amgen Inc., pointed out that Lucentis was approved expressly for use in the eyes, and said the Food and Drug Administration has voiced safety concerns about the repackaging of Avastin for that use.

Avastin, which is sold through wholesalers, will continue to be available to hospital pharmacies and directly to doctors. But it won’t be available to compounding pharmacies as of Nov. 30. The FDA in December sent warning letters to a compounding pharmacy in New England complaining that the practice of splitting Avastin doses for the eye carried risk of contamination and serious eye infection.

Philip Rosenfeld, a University of Miami ophthalmologist who was one of the first doctors to use Avastin in the eye, noted the drug is used for several eye diseases for which neither Avastin nor Lucentis has been approved. “Our need for Avastin just doesn’t go away with providing Lucentis” for wet age-related macular degeneration, he said.

Anne Fung, a San Francisco ophthalmologist, said she worries that some doctors now may try repackaging Avastin themselves without proper safety equipment. The new policy will take Avastin out of a regulated environment and put it into an unregulated environment, she said, possibly increasing the risk of contamination and infections. Dr. Fung said she would likely try to get Avastin from a hospital pharmacy, which could increase the cost of treating patients.

In South San Francisco, Genentech spokeswoman Dawn Kalmar said most macular-degeneration patients are covered by Medicare, and the company helps connect patients who can’t cover their co-payment — which can be $400 a month for Lucentis — with charities that help out. Doctors complain the program is cumbersome, and some underinsured patients fall through the cracks.

14 thoughts on “Dept of Pure Evil: Genentech says “no substitutions”

  1. No socialized medicine but through big pharm.
    No transportation infrastructure but through taxpayer-bailed airlines.
    No Marshall Plan for Iraq but through no-bid private contracts.
    It’s at these points that I really get into regionalism, that I really get into decentralization of government. What rapine couldn’t my sovereign government indulge if it were actually personally responsible to me.
    I’m voting Republican in the legislative elections. Why? Because my reps’ biggest contributors are student loan companies. By the way, no socialized education but through taxpayer-floated Sallie Maes.
    It fucking infuriates me.

    1. I respect your decision, but I’m much more willing to subsidize college education than Bentleys and blowjobs for pharmaceutical company executives.

      1. Hrm.
        There’s plenty of blowjobs and Bentleys to go around when it comes to corporate welfare, and – if I can say – the student loan business is less of an exception than you might think.
        I have some stuff to point you towards, but not handy at the moment. James Surowiecki talks about where all the money actually goes when we float student loan companies, but I forget where. More later.

      2. Hrm.
        There’s plenty of blowjobs and Bentleys to go around when it comes to corporate welfare, and – if I can say – the student loan business is less of an exception than you might think.
        I have some stuff to point you towards, but not handy at the moment. James Surowiecki talks about where all the money actually goes when we float student loan companies, but I forget where. More later.

      3. so
        Heres the URL of that Surowiecki article: http://www.newyorker.com/talk/financial/2007/08/13/070813ta_talk_surowiecki
        I concede that there’s a particular horror about corporate welfare for pharmaceutical companies whom we float supposedly to take care of our health.
        What I’m getting at is my – I think understandable – outrage generally that the “markets do everything better” cant somehow sneakily leads us to contract out government services to the private sector, by no logical, reasonable or sane connection whatsoever. This sort of thing leads to the worst excesses of government and business, and rolls them up into one big old low-fat shit pita.

      4. Re: so
        A document that had me yelling HELLZ YEAH! every other paragraph is one that basically concludes that the benefits of privatization of presumed, not proven, and when subjected to rigors of any scientific or at all logical process, it tends to prove to have been the Wrong Decsion:
        “Pipe dreams
        On the occasion of World Water Day on 22 March, PSI has published a report in collaboration with the World Development Movement and PSIRU. Pipe dreams: the failure of the private sector to invest in water services in developing countries presents the Millenium Development Goals (MDGs) for water, and considers whether they will be fulfilled. It reviews actual investment in sub-Saharan Africa, South Asia and East Asia and includes case studies and pertinent financial information. ”
        http://www.wdm.org.uk/resources/briefings/water/referenced/pipedreamsbriefingref30112006.pdf
        (And in the style of , Fail macro.)

      5. Re: so
        A document that had me yelling HELLZ YEAH! every other paragraph is one that basically concludes that the benefits of privatization of presumed, not proven, and when subjected to rigors of any scientific or at all logical process, it tends to prove to have been the Wrong Decsion:
        “Pipe dreams
        On the occasion of World Water Day on 22 March, PSI has published a report in collaboration with the World Development Movement and PSIRU. Pipe dreams: the failure of the private sector to invest in water services in developing countries presents the Millenium Development Goals (MDGs) for water, and considers whether they will be fulfilled. It reviews actual investment in sub-Saharan Africa, South Asia and East Asia and includes case studies and pertinent financial information. ”
        http://www.wdm.org.uk/resources/briefings/water/referenced/pipedreamsbriefingref30112006.pdf
        (And in the style of , Fail macro.)

      6. so
        Heres the URL of that Surowiecki article: http://www.newyorker.com/talk/financial/2007/08/13/070813ta_talk_surowiecki
        I concede that there’s a particular horror about corporate welfare for pharmaceutical companies whom we float supposedly to take care of our health.
        What I’m getting at is my – I think understandable – outrage generally that the “markets do everything better” cant somehow sneakily leads us to contract out government services to the private sector, by no logical, reasonable or sane connection whatsoever. This sort of thing leads to the worst excesses of government and business, and rolls them up into one big old low-fat shit pita.

    2. I respect your decision, but I’m much more willing to subsidize college education than Bentleys and blowjobs for pharmaceutical company executives.

  2. No socialized medicine but through big pharm.
    No transportation infrastructure but through taxpayer-bailed airlines.
    No Marshall Plan for Iraq but through no-bid private contracts.
    It’s at these points that I really get into regionalism, that I really get into decentralization of government. What rapine couldn’t my sovereign government indulge if it were actually personally responsible to me.
    I’m voting Republican in the legislative elections. Why? Because my reps’ biggest contributors are student loan companies. By the way, no socialized education but through taxpayer-floated Sallie Maes.
    It fucking infuriates me.

  3. I once heard that the drug companies spend a lot of money buying out and shutting down anyone likely to develop a cure for cancer (as opposed to an expensive treatment), because that would threaten their profit model (i.e., ransoming patients’ lives back to them by the month).

  4. I once heard that the drug companies spend a lot of money buying out and shutting down anyone likely to develop a cure for cancer (as opposed to an expensive treatment), because that would threaten their profit model (i.e., ransoming patients’ lives back to them by the month).

  5. Cancer “cures”
    “chemically” similar doesn’t mean they are the same thing, shifting a molecule from L to D can make a significant difference, and the carrier agent could could make a difference as well in the drug’s safety and performance.
    FILL DISCLOSURE: I date a cancer researcher who works for a non-profit. His work in basic research is now being adapted into then drug pipeline with the potential to develop 12 new drugs, out of which maybe two will actually make it FDA approval in seven or eight years.
    Look at the signifcant strides made in cancer treatment over the past two decades, you’ll see great advances in survival rates. Since there are many types of cancer, there is no one “cure.” Cancer is part nature and part nurture, some are more environmentally charges, others genetically. The suble mechanisms of the immune systems, both innate and aptive are just beginning ot be understood thanks to inventions like spectrographs, DNA mapping, and son on. A drug that works on tumors isnt going to work on leukemia
    Researchers are developing vaccines that would stimulate an individual’s immune system based on the specific type of their cancer, and that cancer’s genetic make up, usigf he patient’s body to help fight the disease, rather than just shutting down all cell growth; this is a less toxic model which hopefully will see some progress soon-maybe wiht a decade. Currently chemotherapy works by interrupting the growth of all fast multiplying cells–be they cancer, skin, hair nails or stomach lining. The newer forms of these drugs are far more effective at targeting and do not cause the overwhelming trauma previously seen.
    Before starting to get worried about Big Pharma shutting down cancer research, take a good look at our current funding for National Institutes of Health which has been brutally slashed–less than TWO PERCENT of research grants proposed make it to the funding stage. I wonder where “anyone likely to develop a cure for cancer” is getting the millions and millions of dollars to do their work, in that a “simple” pipette for measure liquids costs a thousand dollars. To run a reasonably sized research facility costs millions and millions of dollars a year.
    Money spent on cancer research, especially within the immune system sector, has wide ranging repercussions for diseases like HIV, psoriatic arthritis (which is treated with a form of chemotherapy developed for cancer), MS, Parkinsons, and so on.
    Yes, wheat grass enemas and organic foods have their place. So does aspirin as a preventative for colon cancer.My mom had esophageal cancer and declined treatment and lived as long as she would have with treatment. She was an exception, but the majority of other friends and family who had cancer would not have lived as long as they did (7 years for my dad; 10 years for a friend who is still alive and kicking ass; who knows how long for one of my oldest friends who had nasal/brain sarcoma 9 years ago–she is still gloriously alive, the saved her face, though another woman in her treatment cycle lost her nose and a third died; one of my guy friends with prostae cancer who is being treated with care and dignity to preserve his very important sexuality, etc; yet my stepfather died in a month from aplastic anemia a kind of blood cancer less than two weeks after beng diagnosed–and he would have GLADLY paid the ransom to live another year)if we did not build on past research and the tens of millions of dollars spent by pharmaceutical companies who use both basic research and applied research.
    We have choices in our medical care, and

  6. Cancer “cures”
    “chemically” similar doesn’t mean they are the same thing, shifting a molecule from L to D can make a significant difference, and the carrier agent could could make a difference as well in the drug’s safety and performance.
    FILL DISCLOSURE: I date a cancer researcher who works for a non-profit. His work in basic research is now being adapted into then drug pipeline with the potential to develop 12 new drugs, out of which maybe two will actually make it FDA approval in seven or eight years.
    Look at the signifcant strides made in cancer treatment over the past two decades, you’ll see great advances in survival rates. Since there are many types of cancer, there is no one “cure.” Cancer is part nature and part nurture, some are more environmentally charges, others genetically. The suble mechanisms of the immune systems, both innate and aptive are just beginning ot be understood thanks to inventions like spectrographs, DNA mapping, and son on. A drug that works on tumors isnt going to work on leukemia
    Researchers are developing vaccines that would stimulate an individual’s immune system based on the specific type of their cancer, and that cancer’s genetic make up, usigf he patient’s body to help fight the disease, rather than just shutting down all cell growth; this is a less toxic model which hopefully will see some progress soon-maybe wiht a decade. Currently chemotherapy works by interrupting the growth of all fast multiplying cells–be they cancer, skin, hair nails or stomach lining. The newer forms of these drugs are far more effective at targeting and do not cause the overwhelming trauma previously seen.
    Before starting to get worried about Big Pharma shutting down cancer research, take a good look at our current funding for National Institutes of Health which has been brutally slashed–less than TWO PERCENT of research grants proposed make it to the funding stage. I wonder where “anyone likely to develop a cure for cancer” is getting the millions and millions of dollars to do their work, in that a “simple” pipette for measure liquids costs a thousand dollars. To run a reasonably sized research facility costs millions and millions of dollars a year.
    Money spent on cancer research, especially within the immune system sector, has wide ranging repercussions for diseases like HIV, psoriatic arthritis (which is treated with a form of chemotherapy developed for cancer), MS, Parkinsons, and so on.
    Yes, wheat grass enemas and organic foods have their place. So does aspirin as a preventative for colon cancer.My mom had esophageal cancer and declined treatment and lived as long as she would have with treatment. She was an exception, but the majority of other friends and family who had cancer would not have lived as long as they did (7 years for my dad; 10 years for a friend who is still alive and kicking ass; who knows how long for one of my oldest friends who had nasal/brain sarcoma 9 years ago–she is still gloriously alive, the saved her face, though another woman in her treatment cycle lost her nose and a third died; one of my guy friends with prostae cancer who is being treated with care and dignity to preserve his very important sexuality, etc; yet my stepfather died in a month from aplastic anemia a kind of blood cancer less than two weeks after beng diagnosed–and he would have GLADLY paid the ransom to live another year)if we did not build on past research and the tens of millions of dollars spent by pharmaceutical companies who use both basic research and applied research.
    We have choices in our medical care, and

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