EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
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June 2012 International techniques and technology February 2011 EW FEATURE 41 Latest anti-VEGF With expanding uses for anti-VEGF also comes the need for innovation. One new anti-VEGF agent available to combat the multitude of retinal conditions that has been found to be successful is Eylea (aflibercept, Regeneron Pharmaceuticals, Tarrytown, N.Y.). "This has been ap- proved in the U.S. for neovascular AMD, but once it is approved and available it can be used in an off- label fashion," Dr. Bressler said. The less frequent dosing schedule makes the drug desirable, she finds. "Dosed eight times over the course of a year and a dosing regimen of monthly for the first 3 months and Q8 weeks for the following 9 months has been shown to be equivalent to Lucentis given every single month for neo- vascular AMD," she said. Once again, however, econom- ics may play a role in in-roads that Eylea ultimately makes globally. On the upside, Dr. Bressler pointed out that from the perspective of price, Eylea has the edge compared with Lucentis."Given that the price of Eylea is $100 per dose and that one could use eight doses over the course of a year compared to 13, you'd be saving money per dose and per ann[um] and allegedly not sacrific- ing vision or anatomical results," Dr. Bressler said. Dr. Bressler suspects that many practitioners in the U.S. will begin to use Eylea in an off-label fashion for a variety of ocular conditions just as they have with other anti-VEGF agents. Ironically, however, in areas of the world where patients are cash strapped, she doesn't see Eylea as making in-roads. "Where economics is the driving factor, bevacizumab has the market cornered," she said. This stems from its early origins. "Because it was developed for can- cer, the price was set for a unit of drug," she said. So, for example, if the drug was priced at $2,000 for a quart and all that ophthalmologists need is a teaspoon, the cost may be a mere $5, something with which there is no competing. "Even if that has to be given every single month, if what's driving decisions is eco- nomics, that is still going to be log- units less expensive," Dr. Bressler said. In contrast, Terence Hurley, spokesperson for Genentech, added, "Even though the monthly whole- sale cost of Lucentis in the U.S. for wet AMD is $1,950, the average cost for 1 year of Lucentis treatment in the U.S. depends on the number of injections a patient receives and typ- ically ranges from $9,750-15,600 (for wet AMD, we currently estimate that in the first year of treatment, the average patient receives ~8 injec- tions and then approximately 5 injections in the second year)." continued on page 42 An ASCRS Membership For every stage of your career Whether you're just beginning or experienced in cataract and refractive surgery, ASCRS is the professional society that's right for every stage of your career. Established Anterior Segment Ophthalmologists Mid-career is perhaps the most challenging period for today's ophthalmologist. The clinical and technological changes have never come faster and the regulatory concerns have never been greater. ASCRS' Annual Sympo- sium and Winter Update offer the education and networking needed to help your practice excel, and our ASCRS MediaCenter provides targeted online content addressing the issues most pressing to you. ASCRS' monthly Journal of Cataract and Refractive Surgery reports on all aspects of anterior segment surgery, and our meetings are focused, well-organized, and highly interactive. eyeCONNECT, ASCRS' online clinical service, lets you share questions and answers with like-minded peers in a private and supportive environment. ASCRS' commitment to fostering excellence through collaborative exchange is unmatched by any other ophthalmic organization. Join ASCRS today! The Society for Surgeons AMERICAN SOCIETY OF CATARACT AND REFRACTIVE SURGERY 4000 Legato Road, Suite 700, Fairfax, VA 22033 • 703-591-2220 • www.ASCRS.org