A whopping 200,000 cases of macular degeneration afflict citizens of the United States each year.  One of the leading causes in vision loss in the United States, the disease has been pondered over by scientists for decades, while they desperately searched for a medication to halt its terrifying effects on the macula of the eye.  By destroying the macula, the disease prevents people from being able to discern objects with their vision as the macula allows one sharp and clear vision.

However, science made strides with time.  Over the decade, we were able to discover two treatments for macular degeneration.  Hope started to blossom for people who faced certain blindness from macular degeneration once we found that Genentech had produced a treatment called Lucentis, which could be injected to halt and in some cases, reverse the effects of the disease.  Unfortunately, while Lucentis is extremely effective, the treatment is also widely expensive.  In fact, in an editorial posted in The New England Journal of Medicine, it was stated that an average treatment of Lucentis cost $2,000.

Luckily, produced also by the same company Genetech was a product called Avastin, which paled in comparison in price to Lucentis but produced generally the same results.  Rather, the treatment for Avastin only costs $150 instead of the ridiculous $2,000 for Lucentis, which is simply a blessing for those who might suffer from macular degeneration blindness one day.

Now, the issue is while Lucentis and Avastin can be used for the same treatment, Avastin was never fully tested for eye treatment.  Lucentis however, was fully tested for macular degeneration and has been proven to work all across the boards.  But whereas there is controversy over the two treatments, I have found that Avastin works perfectly for macular degeneration at much lower of a price than Lucentis.  While the FDA had warned that Avastin, which is meant to treat colon and other cancers, could significantly increase the risk of stroke, heart attacks, and other health effects, it has proven time and time again that this is simply not the case when tested on the eye for macular degeneration.  In fact, findings from both medications tested in the CATT study stated that both medications worked invariably in the same way.  Ultimately, both drugs penetrate the eye’s retina and block growth of abnormal blood vessels and leakage of fluid from the vessels.

In a previous blog post, I lamented about the high costs of using Lucentis in the treatment of macular degeneration over the much less expensive, but equally efficacious Avastin.  I continually receive letters from retinal surgeons who are treating my patients with Lucentis as a primary modality.

I am now sending the following letter to all retinal surgeons who follow this practice pattern, which in my mind, will tax our healthcare resources in the future:

 

Re:  Lucentis Treatment of my patients

Dear XXXXXX:

In receiving referral letters about my patients, most recently XXXX XXXXX, I notice that your group treats my SMD patients with Lucentis as a primary modality. I am concerned as to why you do not try Avastin first, based on the cost efficacy. I feel so strongly about this that I now inform all my patients of the economic impact on our healthcare system.I will also NOT refer patients to practices that use Lucentis as their drug of choice.I certainly do understand using Lucentis when Avastin is not working..

I am enclosing a copy of a post from my blog that fully explains my position on this matter.I would appreciate a call from someone in your practice to discuss this further so that I may again feel comfortable referring patients to your practice.

Sincerely,

Cary M. Silverman, MD

 

It is my hope that this letter will convince these specialists to reevaluate their practice patterns for my patients, if not all their patients.  Should they not comply with my wishes, I will not be referring my patients to these practices in the future!

For more information on macular degeneration, please be sure to check out our blog for your needs. We have information on the value of genetic testing for macular degeneration as one of the most viable traits on getting the disease is related to your genetics.  Plus, there has also been a debate regarding whether or not cataract surgery could lead to macular degeneration due to the amount of increased light light exposure following the procedure but we have evidence that this is actually false and could be the opposite, so make sure that you do your research!

 

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