80 E … It is in this context that the Genentech, • for Genentech, which, as the licensor, earns This communication campaign had a Novartis and Roche laboratories have imple- licensing revenue on sales of Lucentis on the real and significant impact on the mented a set of behaviours (abuse of collec- market in question, behaviour of healthcare professionals tive dominant position) aimed at preserving • and for Roche, which, as the major sharehol- and, consequently, on the structure the position and the price of Lucentis, by cur- der and, since March 2009, sole shareholder of the market. It reduced off-label use bing the off-label use of the anticancer drug in Genentech, earns dividends on the profits of Avastin at many hospitals for the Avastin. made by this US laboratory. treatment of AMD and, more generally, in Ophthalmology. Furthermore, by reducing the fre- A RARELY SANCTIONED Disparagement of Avastin quency with which Avastin was pres- PRACTICE: ABUSE OF Novartis led a global, well-organised commu- cribed and, thereby, maintaining COLLECTIVE DOMINANCE nication campaign that tended to discredit Novartis in a quasi-monopolistic posi- the use of Avastin to treat eye disease, in tion, Novartis’ discourse had the effect The Autorité considered that the three labo- favour of Lucentis. This campaign targeted of preventing Avastin from being used ratories had to be examined as forming a ophthalmologists and, in particular, in comparative trials organised by the “single collective entity” within the meaning Key Opinion Leaders, doctors recognised in authorities in charge of setting the of competition law, as regards to cross-hol- their field who might relay the message put price of medicinal products and thus dings and contractual ties between them. out by the pharmaceutical company. Novar- to support any reduction in the price Particularly noteworthy in this respect are tis also spread this message among patient of Lucentis. the licensing agreements between Genen- associations and the general public. Finally, these practices had a mecha- tech and Novartis, on the one hand, for mar- Novartis was not content to simply discuss nical effect on the pricing of Eylea, keting Lucentis, and between Genentech the objective differences between Lucen- alternative to Lucentis, meaning it was and Roche, on the other hand, for marke- tis and Avastin, nor to faithfully present priced at more or less the same list ting Avastin. the scientific context relating to the use of price as Lucentis. Given the differences in the cost of treatment Avastin. Instead, it disseminated data com- using the two medicinal products, the use paring Avastin and Lucentis, mainly drawing of Avastin rather than Lucentis would entail on a selective and biased presentation of a significant loss of income for each of the the available scientific data, with a view to three laboratories: playing up the risks related to the off-label • first, for Novartis, which, as the licensee, use of Avastin to treat AMD. earns income from sales of Lucentis on the market in question, A L T H C A R E • H E A L T H C A R E • H E A L T TROPER LAUNNA 0202 – erutuf evitisop erom a gniretsoF H C A R E • H