According to the New York Times article, Genentech is offering secret rebates to get eye doctors to use the company's more expensive drug Lucentis, instead of a cheaper alternative Avastin. The drugs are both used to treat macular degeneration, the leading cause of blindness in the elderly. The rebates are legal if they meet certain guidelines, but some doctors question if they are ethical, like Dr. Greg Rosenthal, a local retina specialist.
"One injection of Avastin is about $50 versus the same shot of Lucentis which costs about $2,000," says Dr. Rosenthal.
According to a confidential document obtained by the New York Times, by using the more expensive drug doctors can earn tens of thousands in rebates over the course of a year. "My problem with the program is not that the company wants to incentivize doctors at the least and bribe them at worst to use the product, but my problem is that they are accepting payments for something that is not in the patients' best interest," says Dr. Rosenthal.
Some argue that Avastin is an off label drug when it comes to treating macular degeneration meaning it's approved to treat something else; in this case cancer. But Dr. Rosenthal points out that about 80 percent of drugs in the United States are prescribed off label. He says, "Most of the things we use Aspirin for are off label. Most of Penicillin's uses are off label. When it works for millions of people there is no controversy."
Dr. Rosenthal does not take part in the rebate program from Genetech. We received this statement from the company which says in part that rebate programs are a common business practice across the industry and that the company has rebate programs for many of its medicines. A spokesman says their programs comply with all laws and regulations.
Statement from Genetech:
"Rebate and discount programs are a common business practice across the industry, including in the field of ophthalmology. We have these programs for many of Genentech's medicines.
Genentech offers a program that provides a rebate to Lucentis customers. This program is available to all practices that buy a minimum amount of the medicine. Genentech launched this program following the FDA approval of Lucentis for the treatment of RVO, a new indication.
Genentech structures all its rebate and discount programs, including the new Lucentis program, to comply with all applicable laws and regulations.
Rebate and discount programs help reduce the cost of our medicines for hospitals, pharmacies and doctors."
