Genentech President Defends Companyâ€™s Decision to Embargo Avastin Sales to Compounding Pharmacies
Susan Desmond-Hellmann, MD, MPH, president of product development for Genentech, said she came to speak at todayâ€™s Retina Subspecialty Day program to assure physicians of two things:
â€œOne, Genentech will not interfere with your prescribing choice. Two, Genentech will do everything possible to ensure patients have access to Lucentis,â€ she said.
Dr. Desmond-Hellmann made other assurances to physicians who have been questioning the motives behind the companyâ€™s decision. She said Genentech would not be changing Avastinâ€™s formulation to prevent ophthalmic use of the drug.
She also made a plea to work together in getting past the controversy and continuing to help patients. â€œI ask for your help, we canâ€™t help patients unless weâ€™re working together.â€
â€œStarting today, I hope we can stop the relentless focus on where we have been and start focusing on patients. We know youâ€™re worried about access, but our belief is that you will still be able to get it,â€ Dr. Desmond-Hellmann said.
But physicians in attendance still had the past in focus. Dr. Desmond-Hellmann was preceded by Kirk Packo, MD, who spoke of the physicianâ€™s legal right to use drugs off-label. He also listed a number of recent Genentech decisions that have â€œbuilt up a wall of distrustâ€ between the company and the ophthalmic community. He said the last and most offending decision was the letter the company sent direct to patients suggesting that Avastin was not a good choice.
â€œThe crowning brick in the wall was the direct letter to patients,â€ Dr. Packo said. â€œDr. Desmond, please tear down this wall.â€ His plea was met with a standing ovation, and whoops of support from the crowded auditorium.
â€œWe didnâ€™t make the decision lightly,â€ Dr. Desmond-Hellmann assured the crowd. â€œWe understand your concerns. This decision underscores our commitment to patients.â€ If the company runs afoul of FDA regulations, it canâ€™t continue to manufacture the drugs that patients benefit from today.
Despite a statement from the FDA that it has taken no action to restrict the use of Avastin, Dr. Desmond-Hellmann insisted that the FDA was not OK with Genentech supplying Avastin to compounding pharmacies, and that continuing to supply it to compounding pharmacies would put Genentechâ€™s entire manufacturing operation at risk.
After her presentation, Dr. Desmond-Hellmann took questions from a panel of leading retina specialists and the audience.
One physician asked about the â€œegregiousâ€ cost differential between Avastin and Lucentis. A question that was met with a lot of applause from the audience.
In a presentation here yesterday, George A. Williams, MD, said that according to his economic analysis, Lucentis is 44 times more expensive than Avastin in terms of the costs to Medicare. For the physician, Avastin costs $45 per injection; Lucentis, $2,030.92. For the patient, Medicare co-pays are $9 and $406, respectively.
In response, Dr. Desmond-Hellmann said the company took into account the cost of clinical trials, the price of other drugs, including Macugen and Visudyne, and the efficacy of Lucentis, and decided it â€œwas a good price.â€
Another question: â€œWhat if we canâ€™t get it through a compounding pharmacy, then what do we do?â€
â€œMy expectation is that you will be able to get it,â€ she said, and then added. â€œI might be wrong.â€