At first glance, Kevin Freking's article on Genentech and its two drugs, Avastin and Lucentis--
--appears to be a harsh criticism of the biotech company. Freking shows how Genentech is digging in its heels, refusing even to provide the drugs for a major scientific study, and insisting that no matter how the study turns out, its present pricing structure will not be affected (that is, insisting that patients with wet macular degeneration have to pay $2000 per dose for Lucentis, while Avastin does the same thing when used off label at $60 per dose).
A closer look, however, reveals that Freking has passed on to the reader Genentech's corporate propaganda about the two drugs. Here are a couple of quotes from the article that you can compare with our previous post at this blog: http://brodyhooked.blogspot.com/2007/10/retinal-specialists-get-integrity-award.html
Both drugs target a protein that causes blood vessels in the back of the eye to grow, but Lucentis is a much smaller molecule. It was specifically designed _ at great expense _ to penetrate the retina.
This is bull. Lucentis was specifically designed--at very low expense--to be the classic "me too" or "evergreening" drug. It is simply the active portion of the Avastin molecule--just like Nexium is nothing but the active stereoisomer of Prilosec. Of course the active portion of the molecule is going to be smaller than the entire molecule. The company then spun that as an advantage for eye use. At least some retinal specialists believe the opposite--that the larger Avastin molecule stays around longer and so is more effective.
If Genentech's propaganda were true, then the head-to-head study comparing the two drugs, now underway by the National Eye Institute (no thanks to Genetech) would be expected to show the superiority of Lucentis. Genentech has shown us how much it is willing to bet on that outcome, by saying that regardless of the results of the trial, it won't change its pricing policies. Translated into plain English, that means that all the evidence now available internally to Genetech scientists shows that Lucentis is no better than Avastin.
[Krysta] Pellegrino [Genentech spokesperson] said Genentech's pricing for Lucentis reflects the cost of developing the drug, which the FDA approved in June 2006. The development program included a clinical trial involving more than 6,000 patients at a cost of more than $45,000 a patient.
"It took decades and hundreds of millions of dollars to develop the drug," she said.
More bull, just as above. Drugs are priced based on what the market will bear, not on how much the company spent to develop them. Once you have figured out what portion of a complex molecule is biologically most active, it is a scientific slam-dunk to cleave off that piece of molecule and run it through trials. Genentech miscalculated, as our earlier post showed. They thought they could cow the retinal surgery community into meekly forking over their patients' life savings by threatening them with lawsuits if anyone suffered harm from the off-label prescribing of Avastin. (And by simultaneously flooding their offices with smiling reps pushing Lucentis.) The retinal surgeons, bless them, mostly stuck to their guns and continues to prescribe Avastin off label in large quantities.
This article is an object lesson in how hard health and science reporters have to work to cut through the misinformation that well-heeled companies will spin for them.