TY - JOUR T1 - Ranibizumab (Lucentis) versus bevacizumab (Avastin): modelling cost effectiveness JF - British Journal of Ophthalmology JO - Br J Ophthalmol SP - 1244 LP - 1246 DO - 10.1136/bjo.2007.116616 VL - 91 IS - 9 AU - James Raftery AU - Andrew Clegg AU - Jeremy Jones AU - Seng Chuen Tan AU - Andrew Lotery Y1 - 2007/09/01 UR - http://bjo.bmj.com/content/91/9/1244.abstract N2 - 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. ER -