Lucentis Costing Medicare $1 Billion

An analysis of medicare data shows that Lucentis, a treatment for wet macular degeneration is costing Medicare in the United States approximately $1 Billion per year. Researchers and eye care specialists have indicated there are alternatives to Lucentis that can offer dramatic savings for the program.

In analysing the claims of more than 880,000 medical professionals, it was discovered that the most heavily reimbursed procedure, costing $1 billion for 143,000 patients was for the drug Lucentis. This drug is used to treat age related macular degeneration, an eye disease common in the elderly.

Thirty doctors in Massachusetts alone were paid more than $45 million in 2012.

What is surprising is that the drug Lucentis used to treat macular degeneration costs more than six times more than using an alternative drug, Avastin. However, Avastin is not approved for treating wet macular degeneration but Lucentis is. However, the process of off-label prescriptions allowing the use of Avastin is permitted for treating macular degeneration even though it is not FDA approved for treating the eye disease.

Avastin is a close cousin to Lucentis and has proven both effective and relatively safe for treating macular degeneration. An analsys of the usage shows that a patient would typically pay $50,000 per year to be treated with Lucentis, compared to just $650 for Avastin.


  1. Linda Eklund says:

    What price can possibly be puy on a persons sight? I was 61 when the day came that I could see nothing from my left eye, not even perifferal. Everyday this frightens me as they tell me I have a 50% chance of it occurring in my right eye. I am now 62 , have been fighting this for ten months. I can no longer do many of the things I love doing. Reading is becoming more and more difficult. My depth perception is gone. In all of this I am so thankful that there is a treatment for this debilitating disease. I choose to be thankful for what I have not what I have lost.

  2. Victoria says:

    Unfortunately they do have a price on a persons eyesight. I was diagnosed at 29 years old with wet MD and there is no coverage for any treatments that require to slow the process of this incurable disease. I did receive Avastin which helped but I am now 32 and still require monthly treatments of Avastin and I am a student working on my eduction But found out accommodations didn’t exist . Sometimes I have quite bad reactions to the Avasin and require a week off to recover but I opted for the Avastin as that was my only option and all I could afford due to the time missed from labs I was withdrawn from the course and had to go back next semester and get another student loan which has left me in severe debt and finding employment that will accommodate my needs with this disease doesn’t happen either. I just got let go from the 1 year job I did find after graduation because I couldn’t make there probation requirements due to sick time I used . Your only allowed a day a month for sick leave I required 5 days. It’s been 6 months without any treatment now and my vision has significantly decreased but I can’t afford even the $150 Avastin. I understand that this disease is rare for a young adult but it does exist and is increasing unfortunately. Even with disability I can’t get coverage because I am not 65 years old. I find it extremely difficult to just sit here and let my precious eyesight slip away when I just want to be given a chance, an option to continue to fight against this disease . I miss reading books, I miss being a fully abled contributing to society as any 32 year old should be . I am thank ful for these amazing treatments that have helped so many as far as I am concerned EVERYONE effected by this disease regardless of age, or circumstance should have the access and right to treatment because even without a cure that extra year of still being able to hold on to your sight and those couple of books you got to read is not taken for granted nor is the independence we can hold on to for a lil longer. Even of I never get help and accept what is , I never want anyone else to have to deal wtto h these issues after all I think losing your vision is a burden enough on its own.

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