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VA Halts Avastin Eye Injections Over Infection Risk

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Following a number of serious eye infection reports, some leading to blindness, the U.S. Department of Veterans Affairs (VA) said it has stopped using Avastin to treat wet age-related macular degeneration.

Roche’s Avastin, approved as a cancer drug, is being used more and more to treat the debilitating eye disease, which is an off-label use. Avastin and Lucentis, both made by Roche’s Genentech unit, work similarly; however, Avastin only costs around $50/dose, while Lucentis, which is approved for the eye disorder, costs a significantly higher $2,000/dose. But when compounding pharmacies repackage Avastin into the smaller doses needed for eye injections, the drug can become contaminated with bacteria.

Avastin eye injections has been associated with 21 cases of bacterial eye infections. What’s more, two clusters of infections were reported among patients who received Avastin eye injections 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,” said the VA in a statement, reported Reuters. “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,” the VA added. Reuters pointed out that wet age-related macular degeneration is the number one cause of blindness in seniors.

“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. Genentech has warned against splitting Avastin to treat the eye disease because the drug is not approved for, and has never been tested for that purpose, wrote Reuters. Meanwhile, said Reuters, a large U.S. government-sponsored study released earlier this year revealed that, although Avastin is just as successful in stopping and improving the eye disease as Lucentis, it has more side effects that result in hospitalizations.

In the midst of the controversy, Medicare said it’s considering using Avastin as its drug-of-choice for treating the blinding eye disease, despite the infection risk. Switching to Avastin from Lucentis would save Medicare about half a billion dollars annually, according to a recent report from the Office of Inspector General.

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