Letter: Conflict of interest

“Novartis and other pharmaceutical companies have to be expected to protect their profits ? that being said there is no doubt Avastin is not quite as effective or as safe as Lucentis but the difference is very small and cannot justify the price difference. It is Novartis’s job to try.
As stated by the World Health Organisation, there is an inherent conflict of interest between the legitimate business goals of manufacturers and the social, medical and economic needs of providers and the public to select and use drugs in the most rational way. This conflict is a healthy one and won’t go away.
The price of Lucentis and Eylea is set by the Federal Government based on the amount of benefit that the drug gives to patients.
Government will set a dollar value on benefit which they measure in ‘QUALYs’; they will not pay any more.
If it was not for the costly clinical trials on Lucentis, doctors would not have tried Avastin. The low price of Avastin is due to the doctors high-jacking a product that was produced in large quantities for cancer. Drugs are as cheap as chips or cheaper to produce. The price has nothing to do with costs of manufacture. The Government sets a price for a large bottle on the basis that several bottles would be used per patient per fortnight when treating cancer. The benefit in terms of ‘QUALYs’ was small in cancer patient so the bottles’ price had to be relatively low. One bottle was enough to provide up to 50 intravitreal injections. No wonder it is cheap.
The companies try and set a price that will pay for future drug development and provide a bit for the shareholders; at least 66% goes to R&D. The huge profits have meant there is an extraordinary amount of research into better drugs.
The interesting thing is that the Government is the same as the drug companies; they will approve an off-label medication which is against all their, ethics, protocols and principles, in order to save money. The whole world is corrupt one way or another.
Intravitreal Avastin on one hand has meant hundreds of thousands have been able to afford treatment to avoid blindness and on the other hand a billion less profit means much less investment into better treatments.”