This Article Full Text Full Text (PDF) All Versions of this Article: bjo.2007.116616v1 bjo.2007.116616v2 91/9/1244    most recent Submit a response Read responses to this article Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this link to a friend Similar articles in this journal Similar articles in PubMed Add article to my folders Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Raftery, J. Articles by Lotery, A. Search for Related Content PubMed PubMed Citation Articles by Raftery, J. Articles by Lotery, A. Topic Collections Editor's choice Related Article

Ranibizumab (Lucentis) versus bevacizumab (Avastin): modelling cost effectiveness

¹ Wessex Institute for Health R&D, Medical School, University of Southampton, Southampton, UK
² University of Southampton, Southampton Eye Unit, Southampton General Hospital, Southampton, UK

Correspondence to:
James Raftery, Wessex Institute for Health R&D, Mailpoint 728, Medical School, University of Southampton, Southampton SO16 7PX, UK; raftery{at}soton.ac.uk

Two new drugs provide startling benefits in the treatment of age-related macular degeneration (AMD). The clinical and cost effectiveness of ranibizumab (Lucentis) was compared to that of bevacizumab (Avastin), which costs up to 100 times less. A cost effectiveness model was developed to assess the cost per quality adjusted life year (QALY) over 10 years. For predominantly classic AMD, the efficacy of bevacizumab relative to ranibizumab would have to be around 40% for the latter to achieve £30k per QALY, a NICE threshold. Similar but worse results applied to the other main forms of AMD, minimally occult and occult with no classic lesions. The price of ranibizumab would have to be drastically reduced for it to be cost effective. Continued unlicensed use of bevacizumab raises ethical, legal and policy questions. Public pressure may be the most potent weapon in persuading Genentech to license bevacizumab for AMD.

Abbreviations: AMD, age-related macular degeneration; MC, minimally classic; OC, occult; PC, predominantly classic; QALY, quality adjusted life year

Related Article

BJO at a glance

Creig Hoyt
Br. J. Ophthalmol. 2007 91: 1099. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

				K. Chalkidou, T. Walley, A. Culyer, P. Littlejohns, and A. Hoy Evidence-informed evidence-making J Health Serv Res Policy, July 1, 2008; 13(3): 167 - 173. [Abstract] [Full Text] [PDF]

				S F. Moreno and J B. Paloma Therapeutic anti-VEGF in age-related macular degeneration: Ranibizumab and Bevacizumab controversy Br. J. Ophthalmol., June 1, 2008; 92(6): 866 - 867. [Full Text] [PDF]

				K. D Frick and D. G Walker Economic welfare implications of differently structured vision care markets Br. J. Ophthalmol., March 1, 2008; 92(3): 301 - 302. [Full Text] [PDF]

eLetters: