for Poik and Buffy and others…

http://www.tcpinnovations.com/drugbaron/?p=271

Thanks neo. Interesting.

Thanks neo. Friend used to work for GSK in Europe…their drugs don’t fail apparently, they just don’t do the ‘right’ studies…

I read a couple of papers this afternoon about Lucentis and Avastin (injections into the eye for an attempt at treating macular degeneration). The first was titled “Replacing ranibizumab with bevacizumab on the Pharmaceutical Benefits Scheme: where does the current evidence leave us?” and the second was “Response to Replacing ranibizumab with bevacizumab on the Pharmaceutical Benefits Scheme: where does the current evidence leave us?”

I love it when they fight in the journals. I particularly liked this bit “…Beaumont’s highly personal interpretation of the published data and the results and his criticism of the methodology of the study are convincingly attributed to a lack of understanding of the study and its structure…”

I don’t know if you have access to Clinical and Experimental Optometry poikilotherm, but if you do, you might find the two pieces amusing. It’s the September 2012 issue pp538-543.

(It’s basically that the more expensive drug is on the PBS when really most places in the world use a cheaper one. Both made by the same company. Guess which one the company wants to keep on the PBS? The research is riddled with conflict of interest)

buffy said:

I read a couple of papers this afternoon about Lucentis and Avastin (injections into the eye for an attempt at treating macular degeneration). The first was titled “Replacing ranibizumab with bevacizumab on the Pharmaceutical Benefits Scheme: where does the current evidence leave us?” and the second was “Response to Replacing ranibizumab with bevacizumab on the Pharmaceutical Benefits Scheme: where does the current evidence leave us?”

I love it when they fight in the journals. I particularly liked this bit “…Beaumont’s highly personal interpretation of the published data and the results and his criticism of the methodology of the study are convincingly attributed to a lack of understanding of the study and its structure…”

I don’t know if you have access to Clinical and Experimental Optometry poikilotherm, but if you do, you might find the two pieces amusing. It’s the September 2012 issue pp538-543.

(It’s basically that the more expensive drug is on the PBS when really most places in the world use a cheaper one. Both made by the same company. Guess which one the company wants to keep on the PBS? The research is riddled with conflict of interest)

Yea, the NHS has had this argument in the UK, the cheap stuff won…

But, due to our ‘system’, it’s unlikely that the cheaper one will be changed (as the company funds both and has to apply for PBS approval – they ain’t interested in getting their cheaper stuff approved when they get the dollars from the other one)…so, it’ll rely on some ‘good samaritan’ to apply to have their cheaper drug on the PBS for that indication (don’t like their chances $$). Plus, they’d have to have it registered for that use by the TGA even though it is the same thing AFAIK too (even more $$$).

poikilotherm said:

But, due to our ‘system’, it’s unlikely that the cheaper one will be changed (as the company funds both and has to apply for PBS approval – they ain’t interested in getting their cheaper stuff approved when they get the dollars from the other one)…so, it’ll rely on some ‘good samaritan’ to apply to have their cheaper drug on the PBS for that indication (don’t like their chances $$). Plus, they’d have to have it registered for that use by the TGA even though it is the same thing AFAIK too (even more $$$).

Actually, they may waiver the fees, but, it’s still a lot of work for one to do without ‘reward’.

The response piece suggests optometrists monitor their ophthalmologists and think about who they send people to. There is also ‘discussion’ about the protocols. Some are just doing monthly injections pretty much forever….which is no longer considered optimum. I have people I refer to who do that. I try not to refer to them for mac degen.

Geeks fighting is always amusing buffy. No access unfortunately.

Geeks fighting is always amusing buffy. No access unfortunately.

buffy said:

The response piece suggests optometrists monitor their ophthalmologists and think about who they send people to. There is also ‘discussion’ about the protocols. Some are just doing monthly injections pretty much forever….which is no longer considered optimum. I have people I refer to who do that. I try not to refer to them for mac degen.

Yea, the drug reps use some creative language when they are talking to the doctors here. Seems common to use over the recommended time frame of many different drugs.

Oh, that’s a shame. It doesn’t happen all that much in the optometry journal, but I have followed topics over several issues in the letters in the ophthalmology journals.

Actually, the first piece on this occasion was written by BAppSc(Optom)(Hons) – saying the cheaper one has not been proven – and the second by an MD MBBS FRANZCO FRCS FRCSOphth FEBO – saying everyone else uses the cheaper one, and look at the research properly!

I am particularly interested in this because I see so many old folk. And there were never this many people with macular degeneration before there was a drug to use for it…….

buffy said:

I am particularly interested in this because I see so many old folk. And there were never this many people with macular degeneration before there was a drug to use for it…….

Yea, tax dollars well spent…

lolz, just looked at the price difference:

Avastin = $1789 ($4.47/mg)
Lucentis = $1900 ($826/mg)

http://www.nejm.org/doi/full/10.1056/NEJMp068185

It’s sinful, really.

That’s an interesting piece poikilotherm. I was under the impression that it was a group of ophthals in Perth (Australia) who decided to try the cheapie out.

I remember when patients brought me all their consent paperwork for a translation when our local ophthal was giving them a choice between the two drugs. Before it went on the PBS, there really wasn’t a choice for pensioners…..

buffy said:

That’s an interesting piece poikilotherm. I was under the impression that it was a group of ophthals in Perth (Australia) who decided to try the cheapie out.

I remember when patients brought me all their consent paperwork for a translation when our local ophthal was giving them a choice between the two drugs. Before it went on the PBS, there really wasn’t a choice for pensioners…..

Nah, its old hat really. Au too scared of litigation until somewhere else has tried it, with moat things AFAIK.

Looks like Lucentis went PBS in 2007 here. That 5 years has flown!