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Overall, three drugs available to treat diabetic macular edema all did a good job, researchers found in a national clinical trial. One costs $60 per injection, the others cost over $1,200 and $1,850. But the most expensive one did best in a subset of patients.
Aflibercept (Eylea/Regeneron) did better in treating diabetic macular edema (DME) than a far cheaper alternative bevacizumab (Avastin/Genentech) in a subset of patients who started treatment when their vision was 20/50 or worse.
The finding was made in a three-year National Institutes of Health-funded clinical tria in whichl researchers compared three drugs, aflibercept, bevacizumab and ranibizumab (Lucentis /Genentech)
Gains after two years were about the same for aflibercept and ranibizumab, though at the one-year point, aflibercept had shown a clear advantage.
In patients whose vision was better at the start of treatment (20/32 or 20/40) the three drugs were about equal in effectiveness.
The trial was conducted by the Diabetic Retinopathy Clinical Research Network, funded by the NIH’s National Eye Institute.
In a news release describing the results, NEI’s Paul Sieving, MD, PhD, said “eye care providers and patients can have confidence in all three drugs.
Based on Medicare allowable charges, the per-injection costs of each drug in the doses used in the study were only $60 for Avastin but $1,200 for Lucentis and $1,850 for Eylea.
The trial involved 660 patients with DME and ws done in 89 sites across the US.
The study results were published in Ophthalmology. The lead author of the study is John A. Wells, MD, a retinal specialist at the Palmetto Retina Center, Columbia, SC.