Where Drug Dollars Go
The way doctors across the U.S. treat a chronic eye disease, known as wet age-related macular degeneration (once a leading cause of blindness among older people) varies from place to place.
The three drugs doctors choose from are Lucentis, Eylea, and Avastin. Lucentis costs the most, at about $2000 per dose, and Eylea is slightly less, but Avastin is much cheaper, at about $50, according to 2012 data…Lucentis, the most expensive drug, and Avastin, the cheapest, have been shown to be equivalently effective in repeated randomized trials.
The more money towards Lucentis looks to be more rural, less populous places. Nebraska, Kentucky and the lower parts or Alabama and Florida take up the most severe red parts of the map.
That doesn’t explain the North and Northeast, like Montana and the Dakotas. Looks like those places spend less on it and find alternatives.
Nebraska also has the highest cost of doctor administered drugs per Medicare enrollee. There must be some correlation.
“…age-related macular degeneration, that among older people had long been a leading cause of blindness.”
Probably this.
If you have macular degeneration, you better hope you don’t live in Nebraska.
T. Boone Pickens has the cure!
“The only difference is that Avastin is not sold in convenient doses and so must be divided up, adding another step and a very small risk of contamination.”
I would think that this is kind of a big deal. How small a risk of contamination?
Its usually not that small when they don’t disclose how small the risk is.
Compare the usage of Lucentis and the regions where ophthalmologist receive more from Medicare. That should paint a clear picture of the incentives doctors have of prescribing the more expensive drug.
I honestly don’t see why, if the significantly cheaper drug treats the problem just as well as the most expensive, the cheaper drug isn’t used more often.
Because people are led to believe that the more expensive drugs work better
Wow, an off-label use that people finally approve of?
As for the risks, in 2011, there were a number of strep infections following eye injections of pharmacy repackaged Avastin. At least 12 people are known to have been infected, some lost all of their remaining sight. Might this have affected use of Avastin in Florida?
Plus, there seems to be some evidence that Avastin and Lucentis may have different side effect profiles. This is a different issue than “outcomes,” where as far as is known they have similar results in measures of visual acuity and central macular thickness.
It is interesting that Kansas is so red.
So you’re suggesting that the one eye doctor who treats this condition in Kansas prefers Lucentis.
I’m assuming yes
Kansas. What’s the matter with Kansas?
Perhaps that’s the real reason for Sebelius’ resignation:
Her home state desperately needs her demonstrated cost-saving expertise.