EyeWorld is the official news magazine of the American Society of Cataract & Refractive Surgery.
Issue link: https://digital.eyeworld.org/i/111385
90 EW MEETING REPORTER Reporting live from the 2013 APAO-AIOS Congress, Hyderabad, India February 2013 He compared prices of two commonly used anti-VEGFs, Lucentis (ranibizumab, Genentech, San Francisco), U.S. Food and Drug Administration approved, and Avastin (bevacizumab, Genentech) used off-label. The two have similar profiles: The duration of action for Lucentis is four weeks, while the duration of action is four to six weeks for Avastin, and ocular and systemic safety is comparable. But the cost of the two drugs is significantly different. ���It is 40,000 to 60,000 rupees per dose for ranibizumab and 2,000 to 5,000 rupees per dose for bevacizumab,��� Dr. Azad said. The total estimated cost of antiVEGFs with a four to six weeks frequency dosing at 20 expected doses for Lucentis is 800,000 to 1,200,000 rupees, while Avastin is 40,000 to 100,000 rupees���and another antiVEGF, Macugen (pegaptanib sodium, OSI Pharmaceuticals, Melville, N.Y.), has a more initial estimated cost, at 45,000 rupees, going up to 50,000 rupees, totaling 900,000 to 1,000,000 for 20 doses. Cost burden, protocol At such costs, it is not difficult to understand how many patients cannot afford their treatment for the blinding disease, regardless of the consequences to their vision. In his own treatment protocol, Dr. Azad first diagnoses CNVM/ recurrence and then assigns three monthly dose treatment of antiVEGF with PRN dosing based on visual acuity, OCT, and fluorescein angiography eye test, as needed. With his current protocol, for the first year, with 30% to 40% remission, five doses are expected when using any of the three drugs, dropping to four doses expected in the following years, impacting cost in a positive way by slightly reducing the overall financial burden, he said���but still, that cost does not account for other coexistent costs at present, such as OCT and fluorescein angiography eye test. Editors��� note: Dr. Azad has no financial interests related to his comments. The future of endothelial keratoplasty ���To understand the future, you need to understand the past,��� said Jodhbir S. Mehta, M.D., Singapore. It has been 108 years since the first penetrating keratoplasty was performed. Penetrating keratoplasty became the gold standard for endothelial replacement, but even after more than a century of development, it remains problematic, including a corneal endothelial cell loss of up to 70% at 10 years. The trend today is increasingly toward targeted replacement of diseased corneal layers. Endothelial keratoplasty represents a shift in the paradigm that has dominated for almost a century. However, Dr. Mehta and his colleagues at the Singapore National Eye Centre (SNEC) soon found that the typically shallow Asian eye presented a particular challenge to the