06 Dec Eylea As Good As Lucentis
Last month, the FDA approved Eylea (VEGF-Trap, aflibercept) for the treatment of wet macular degeneration. The new drug does not need to be injected as often as Lucentis, yet it seems that the visual improvement is the same; that is, fewer injections yield similar improvement in vision…for the first year of therapy.
Keep in mind that we are always interested in a drug’s ability to improve vision, and sustain these improvements.
Eylea Improves Vision and is Sustained
This week, results from patients receiving these eye injections for a second year were reported. It was disclosed that little benefit was seen between the two drugs for the second year of treatment, i.e. the visual results were sustained and comparable.
During the second year of treatment, both drugs were given “as needed” in contrast to the first year with regimented dosing; monthly injections for Lucentis and bimonthly for Eylea.
Stock Drops After News
Regeneron’s stock (Regeneron manufactures Eylea/aflibercept) apparently plummeted after the news. Wall Street seems disappointed that the the new drug may not be as cost effective nor as convenient as initially hoped.
What Does This Mean?
I think this validates the new drug. The study confirms that visual improvement is indeed achieved with Eylea and is also maintained.
Clearly, I expect that Eylea will yield the same visual results over the first year of treatment, yet requiring fewer injections. This means fewer trips to the doctors, fewer diagnostic texts, fewer rides from family and friends.
The data recently presented only confirms that Eylea works. Remember, few drugs, including Lucentis, are actually used in the same fashion as when they were FDA approved, that is, we should be happy that Eylea improves vision for the 2nd year…nothing more.
More convenience, equal results, cost savings (from fewer office visits) can be translated into improved compliance (patients willing to continue treatment) and that also means MORE patients may be willing to undertake treatment!
This is exciting!
IqbalPosted at 03:58h, 07 December
It is good to have yet another option. How about its cost which is also an important aspect? What is the price of an injection at the moment?
Randall V. Wong, M.D.Posted at 11:03h, 12 December
There are two charges, the cost of the actual injection and the cost of the medicine. I think Eylea will be priced at $1800. The surgeon’s fee (cost of the injection and the office visit) can vary widely depending upon where you are located. I just called my office, we get reimbursed (what insurance might pay) between $150 and $200 dollars as of 2011.
SuzyPosted at 20:38h, 07 December
My mother has wet md. She has received Lucentis in France, where she lives, and Avastin here in Los Angeles through the Jules Stein eye institute at UCLA. She heard that at Jules Stein they were trying new techniques with stem cells.
Have you heard of this and do you think this will help?
Randall V. Wong, M.D.Posted at 11:04h, 12 December
Not aware of any success with Stem Cells, period.
My usual statement is the following; getting the stem cells to survive after transplantation into the eye is one problem…..developing a technique to do this safely is quite another.
SuzyPosted at 13:09h, 13 December
Dr. Wong, thanks for your response. You just saved my mother a lot of curiosity and possible aggravation about the unknown.
floatersPosted at 14:00h, 13 December
Dear Dr. Wong,
Please help this cause by linking the words “disease” with floaters. It will hopefully lead to greater awareness of our issues. Following is an excerpt from editorial published by Dr. J Sebag in Nov 2011.
“”In view of the fact that floaters are perceived by patients as a significant health problem, it is incumbent on the medical profession to develop effective and safe methods to cure this disease.3 Despite claims on the Internet and in the lay literature, eye drops have no effect on floaters. Neodymium:yttrium–aluminum–garnet laser treatments also are not effective. Vitrectomy is effective and needs to be safe. An important consideration in this regard is the recent finding that in a study of 695 vitrectomy cases, the risk of RRD was reduced from 4.9% to 1.1% (P = .04) by using small-gauge vitrectomy instrumentation.5 Thus, until pharmacologic vitreolysis is able to meet the demands of patients with floaters, minimally invasive, sutureless vitrectomy using small-gauge instruments without PVD induction seems to be an effective and safe approach.6”
Safety of Vitrectomy for Floaters
Christianne Wa, Jerry Sebag
Available online 21 November 2011.
Randall V. Wong, M.D.Posted at 14:32h, 21 December
Not sure how I can help. Please advise.
Abdulla Abdulwahab(Iraqi National)Posted at 08:53h, 20 December
IAs a result of cataract operation in both eyes,i had dry amd in the left eye and wet amd in the right eye. It is good news to hear of the eye injections (EYLEA)- Please advise if it would possible to make an order with the manufacturers directly with a possibility of price reduction
Randall V. Wong, M.D.Posted at 14:26h, 21 December
Not aware that this is possible.
Jon RobertsPosted at 18:32h, 14 January
Is there any information available on switching from Lucentis to Eylea? The report you describe above would suggest to me that there might be some benefit in the early months of treatment, but not much after the first year. Thank you.
Randall V. Wong, M.D.Posted at 20:03h, 19 January
No direct data per se. When used side by side, the first year offers benefit, but the two drugs are similar after one year.
Haven’t read anything about switching from Lucentis to Eylea, but I am sure this will start to make news in the next year or so.
Lowell NigoffPosted at 13:54h, 20 January
Dear Dr. Wong,
Quote from Study: Less-Expensive Avastin Treats Age-Related Macular Degeneration as Well as Lucentis, By Daniel J. DeNoon WebMD Health News
“On all measures of visual acuity, the two drugs were virtually identical,” study leader Daniel F. Martin, MD, chairman of the Cole Eye Institute at the Cleveland Clinic, said at a news teleconference.
So if results are “virtually identical”, and Lucentis cost 30-40 time as much as Avastin, might I conclude that the treating physician is making a lot more money (or receiving other benefits) selling the more expensive drug?
Randall V. Wong, M.D.Posted at 09:12h, 15 February
Sorry for the delay. Somehow I “lost” your comment.
Actually, most of us are lucky if we “break even” with Lucentis. We bill the same for injecting Avastin or Lucentis and are paid the same regardless of the drug injected.
We often lose more money with Lucentis. We have to buy the drug from the company. Let’s say it costs $2000 per injection. Regardless of what we charge, Medicare pays a flat fee, less 20%. In this case, that equals $400. The patient has to come up with that “gap” as an out of pocket expense if there is no co-insurance.
By law, we can NOT collect over what Medicare has agreed as a fair price. Hence, often we lose up to $400 per injection.
The act of injecting is all we can possibly “net” and as I said, is the same regardless of drug.
Thanks. Good thought.
Mary RayPosted at 19:47h, 05 July
Hello Dr. Wong,
My husband has wet AMD and has received 3 injections of Eyelea over the past 4 months. Today, after doing a new scan which showed continued growth of abnormal vessels, the Dr. switched to Lucentis. Is there a chance that if he didn’t respond to Eyelea, he will to Lucentis? We are discouraged.
Randall V. Wong, M.D.Posted at 06:43h, 10 July
By “continued growth” do you mean persistent or larger? There is a chance that switching anti-VEGF meds may help. Many times; however, it takes more than 4 months to get effective control of the neovascularization, regardless of the medicine employed.
Don’t give up.
Michele NarayanasamyPosted at 15:26h, 14 July
I stopped responding to Avastin after a year and a half, went on to Lucentis, worked for the first year and now no longer responding, so I am now going to Eylea. If I am indeed also becoming resistant to this new drug, what will my doctor do? He has no answer for me yet….
Randall V. Wong, M.D.Posted at 14:09h, 27 July
Can’t really speak for your doctor. Eylea may be a possibility, too.
Mercedes coléPosted at 18:06h, 23 August
Two on this ago I discovered a cloud on my right eye and I was told that I now have AMD I was given 2 monthly Lucentis injection and is working really god. I’m able to read once again with that eye.
I really appreciate all the information on this page Dr Wong
Thank you Metcedes Cole
Randall V. Wong, M.D.Posted at 12:45h, 25 August
Thank you so much and best of luck!