79 AMD TREATMENT Abusive practices: three laboratories sanctioned The Autorité imposed fines worth a total of €444 million on the pharmaceutical companies Novartis, Roche and Genentech, for abusive practices designed to sustain the sales of Lucentis for AMD treatment (age-related macular degeneration) to the detriment of Avastin, a competitive medicinal product that is 30 times cheaper. A look back at a high-profile case that concerns the main cause of visual impairment in people over 50. AMD TREATMENT: In response to the continuing off-label use of A PUBLIC HEALTH ISSUE Avastin, the public authorities in many coun- tries decided to launch various research pro- Age-related macular degeneration (AMD)grammes to test the effectiveness and the is the main cause of low vision for peopleexistence of any adverse effects linked to €30/40 over 50 in industrialized countries. It causessevere impairment of central vision, whichis particularly present in the form of darkprescribing Avastin for the treatment of AMD. FOR AN INJECTION spots perceived by the patient in the middle OF AVASTIN of its vision. It is therefore a public health and financial challenge for health systems COMPARED TO because the available treatments are parti-The large gulf cularly expensive. A single vial of Avastin can be used to administer several injected doses, 1,160 The Genentech laboratory has developedbringing the unit cost per injection to € a drug, Lucentis, to treat AMD. It also deve-around €30/40, whereas the face value loped another medicine, an anti-cancer drug,of Lucentis ranged from €1,161 to Avastin. Doctors realised that Avastin had€647 between 2007 and the end of positive effects for patients with AMD. This2015 (a difference of at least a factor of 20, and even 40 at the beginning of FOR AN INJECTION OF LUCENTIS discovery led to the development of its use,the period). outside of marketing authorisation (MA), toDecision 20-D-11, paragraph 1155 treat this disease, as Avastin was 30 times (translated) less expensive than Lucentis. … ACTIVATING TRANSFORMATION