Increased scrutiny by EU5 health authorities will encourage off-label use of Avastin for wet-AMD

6 November 2014

Cost-constrained health authorities in the EU5 (France, Germany, Italy, Spain, and the UK) are increasingly scrutinizing the cost to the health care system of anti-vascular endothelial growth factor (VEGF) agents labeled for wet age-related macular degeneration (AMD).

In fact, legislation has recently been enacted in France and Italy to allow for off-label use of Roche’s Avastin (bevacizumab), which is priced significantly lower than other anti-VEGF drugs when compounded for ophthalmic administration, according to a new report from Decision Resources Group. The majority of surveyed retinal specialists in these markets anticipate these legislative decrees to at least moderately increase their prescribing of Avastin for wet AMD.

Other key findings from the European Physician & Payer Forum report include:

Impact of biosimilar anti-VEGF therapies: Among surveyed EU5 retinal specialists, 31% to 48% suggest that they would administer biosimilar ranibizumab (Novartis' Lucentis) to their treatment-naive wet AMD patients if the drug has clinical trial safety data, a lower out-of-pocket cost, and health authorities’ support to prescribe a biosimilar ahead of the brand. Interviewed payers expect that retinal specialists would be encouraged to prescribe an approved biosimilar ranibizumab first line.
Most-effective market access levers: Interviewed EU5 payers suggest that demonstration of superior head-to-head efficacy versus Lucentis will position emerging therapies favorably to gain formulary placement, and possibly first-line treatment status.

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