According to Maureen MacDonald, Nova Scotia’s health minister, the province may pay for Lucentis treatments for macular degeneration payments if it can afford the drug.  Lucentis treatments for Novia Scotians is estimated to have a cost of $5 million annually.

MacDonald has indicated “We’re reviewing that drug as part of the budget process.”

For those people in Nova Scotia diagnosed with macular degeneration having access to Lucentis treatments would be a major step forward in treating the degenerative eye disease.  Lucentis treatments are typically injected into the eye of macular degeneration patients suffering from the rapidly progressing version of the eye disease – wet macular degeneration.

Currently the cost of Lucentis treatments for Nova Scotians costs approximately $1,600 per month.  People who are now diagnosed with macular degeneration must pay for these Lucentis treatments themselves while other provinces such as Newfoundland, Ontario and Quebec provide funding for Lucentis.

There is growing support throughout Nova Scotia for the government to provide coverage for Lucentis treatments for macular degeneration.  People are advocating use of the sight saving treatment for the eye disease.

New Brunswick joins Newfoundland and Labrador as only the second Atlantic Canadian province to provide coverage for Lucentis treatments.  With the annoucement, New Brunswick joins Newfoundland and Labrador, Quebec, Ontario, British Columbia, Saskatchewan, the Yukon and Alberta in providing treatments for patients diagnosed with wet macular degeneration.

People diagnosed with wet macular degeneration generally experience a rapid deterioration of their central vision that eventually leads to blindless.  Lucentis has become the treatment standard for wet macular degeneration and has been shown to dramatically improve the vision in the majority of the patients receiving the injections.  In clinical trials, Lucentis was shown to improve the vision of approximately 40 percent of patients to a visual acuity of 20/40 or better.

In March 2008, the Common Drug Review (CDR), Canada’s national drug review panel recommended that Lucentis be covered under provincial drug plans.  Ontario and Quebec were the first provinces to provide coverage of Lucentis for macular degeneration.

Lucentis is designed specifically for use in teh eye and is administered through injections.  Wet macular degeneration is characterized by the formation of abnormal blood vessels and leakages behind the retina that results in the loss of central vision.  Lucentis treatments targets these abnormal blood vessels and prevents further leakages from occurring.

With New Brunswick being the latest Canadian province to provide coverage for Lucentis, one can only hope that the remaining provinces will follow suit.

VICTORIA, B.C. — The B.C. government will start funding two new drugs to treat people suffering from a disease that could cause blindness for seniors.

Health Minister George Abbott said Lucentis and Avastin will be available starting June 1 to patients dealing with age-related wet macular degeneration, with the recommendation of a retinal specialist.

B.C. currently funds only one drug – Visudyne – but it hasn’t proven effective for many seniors who’ve had to spend over $1,600 per treatment every six weeks for Lucentis.

Abbott said that besides slowing or stabilizing the disease, the newly funded drugs may even improve patients’ vision.

The announcement comes days before the B.C. election campaign officially begins April 14.

“The drugs have been under review for some time,” he said.

Ontario and Quebec already pay for the two drugs.

Abbott said Saskatchewan recently announced it would be funding only Lucentis while Manitoba will be footing the bill for Avastin.

Last December, public health authorities in Canada investigated a spike in eye inflammation among patients being treated for macular degeneration with the cancer drug Avastin.

The first cases were noticed in B.C. but Abbott said only one lot of the drug that was shipped worldwide – except to the United States – was responsible for the problem.

“It has not been a generalized problem with respect to Avastin,” he said.

Claude Dufour, 72, was thrilled to hear B.C. will be funding Lucentis. He said he has spent over $15,000 on it since last year.

The Kamloops, B.C., resident said his specialist tried the other two drugs but they didn’t work for him.

“Everybody that I talked to who’s taking Lucentis, it’s working,” said Dufour, who had already lost the sight in his right eye after macular degeneration struck over four years ago.

“In my right eye I was getting Avastin and I’m blind in my right eye,” he said.

Dufour said while he has been able to afford Lucentis up to now, he couldn’t have kept shelling out money for it.

He said he has been lobbying the government to fund the drugs to help seniors at risk of going blind.

“Last time I was at the hospital when I got an injection, there was a lady in her 80s and an older fellow and they couldn’t afford Lucentis,” he said. “She was getting the Avastin and she looked like she was going blind.”

Dufour said he’s angry the government waited until before an election to announce funding for the drugs.

“They’re hijacking seniors for their bloody election,” he said.

British Columbians go to the polls on May 12.

He said B.C. should have followed the lead of Ontario and Quebec to quickly approve vision-saving drugs.

Abbott said up to 3,500 British Columbians will receive one of the three treatment drugs each year to combat the disease that can quickly rob a senior of their eyesight.

The province expects to spend about $15 million a year on all three drugs.

With approximately 20,000 people in Newfoundland and Labrador suffering from Macular Degeneration, this announcement is major news.  With only 10 percent of the diagnosed cases of macular degeneration being the wet type of the eye disease, this means that approximately 2,000 people can benefit from this funding announcement.

Lucentis being covered for treating macular degeneration in Newfoundland and Labrador is a major announcement.  The CBC has a podcast on Macular Degeneration where it talks to the CNIB in St. John’s, Newfoundland.

Normally, patients would require between 3 and 15 injections of Lucentis.  What is not clear about the program announced by the Newfoundland and Labrador Government is how many treatments patients will qualify for.  What is clear is that the availability of Lucentis now means that seniors and the aging no longer have to worry about financing their treatments for wet macular degeneration.

Treatments of Lucentis are anticipated to cost approximately $2,000 per dosage and looking at the math, there is a potential to quickly consume the $2.8 million in funding announced.  However, being only the fourth province to step up to the plate and cover this drug is a major step.  It now means that those who need Lucentis to save their vision no longer have to worry about mortgaging their homes tao pay for treatments.

Public health authorities are trying to draw attention to the problem with the Avastin treatments for macular degeneration in hopes of determining if this is occurring across Canada.

The problem is believed to stem from a particular lot of the drug that was distributed widely around the world but not in the United States.  According to public health authorities in Canada, the affected lot of Avastin is lot number B3002B028.

Roche, the Swiss pharmaceutical company that manufactured the drug, has been cooperating with both Health Canada and the British Columbia Centre for Disease Control.  Ophthalmologists have already been alerted of the problem with Avastin that may be used for macular degeneration treatments.

Avastin, originally developed as a cancer drug, has not been approved for use as a treatment for Macular Degeneration.  Roche has indicated that it does not recommend using Avastin to treat macular degeneration.  According to Samantha Ouimet, a spokesperson of Roche Canada, “Absolutely we do not recommend this.  They’re taking it out of its packaging, repackaging it and injecting it into people’s eyes.  This comes in a bag and it’s meant for intravenous use for people with cancer.”

Roche has resisted warning people to not use Avastin as a treatment for macular degeneration because the statement could be interpreted as promoting the off-label use of the drug to treat the eye condition.

The problem with the Avastin treatments were first detected in October 2008 when British Columbia ophthalmologists began detecting problems with people treated with Avastin for macular degeneration.  These patients began experiencing acute intra-ocular inflammation at rates much higher than was previously known.  After an investigation, it was noted that the rate was almost 10 times higher among patients treated with Avastin from the lot in question.

According to officials, there are no problems reported with using Avastin as a macular degeneration treatment in other countries and no reports of problems in cancer patients who received treatments of Avastin from the same lot.

The inflammation caused with the treatment of Avastin causes cloudy vision, but appears to clear up after a short period of time.

Roche has indicated that there have been no problems discovered in the production process used for the lot of Avastin and that there has been no problem determined with the vials of drug either.  The investigation is ongoing.

Macular degeneration is the leading cause of blindness in the elderly, and Avastin has been used for some time as an off-label treatment for wet macular degeneration.

Lucentis has become the leading treatment for the wet macular degeneration and while it dramatically improves a person’s quality of life, it does come at an expensive price tag.  The use of anti-VEGF drugs to to treat macular degeneration has become the leading treatment for macular degeneration.  The use of drugs such as Lucentis has been on the rise in France as health authorities in that country have authorized full reimbursement for what they are dubbing the best drug shown to provide the best standard of care to those people diagnosed with macular degeneration.

The French Government has invested heavily in the program to provide macular degeneration patients with the best treatment for wet macular degeneration, Lucentis (ranibuzumab), produced by the pharmaceutical company Genentech.  This has been done without regard for the price of the drug and is being done to simply provide the best standard of care to patients.  Authorities have indicated that this is no different than providing cancer patients with the best drugs for treating their disease.

In making the resources available for Lucentis treatments for macular degeneration, the French Government has raised the bar very high for other governments.  While other countries such as Canada and the United Kingdom are contemplating whether they will provide coverage or establishing criteria for which coverage will be available, the French Government has indicated there is no predetermined limits on the number of treatments for this eye disease.   Patients will be monitored regularly to determine the number and frequencies of Lucentis injections required.  There is no criteria to meet for coverage, it is simply provided to all macular degeneration patients requiring the treatment.

Patients are free to obtain the Lucentis treatment at whatever health care centre they have been recommended to by their physician, regardless of it being a private or public facility.

By providing coverage for Lucentis, France has also eliminated the controversy surrounding the off-label use of Avastin (bevacizumab).  Authorities have indicated that there is no need for physicians to prescribe a drug that has not been through clinical trials in treating the eye disease.

For those patients where Lucentis and the other anti-VEGF drugs are not an option, patients will still be able to take photodynamic therapy (PDT) utilizing Visudyne and a cold laser.

Shortly after the July 30, 2007 Notice of Compliance issued by Health Canada to Novartis Ophthalmics, Novartis Pharmaceuiticals Canada Inc for its wet macular degeneration drug Lucentis, the province of Quebec, Canada announced it would provide funding for the drug.  Quebec’s funding came even though the Common Drug Review Committee (CDR), the advisory body that determines and recommends which drugs should be covered by provincial health authorities failed to provide a recommendation for Lucentis.

Quebec’s decision to provide funding for Lucentis went against the recommendation of the CDR.  Recognizing the potential of Lucentis to treat the eye disease wet macular degeneration, the Quebec government began providing funding.

Following suit, the Ontario government began to evaluate Lucentis and its benefits for treating the eye disease.  On March 13, 2008, the Ontario government announced that it would be following Quebec’s lead and providing funding coverage for the drug Lucentis.

The CDR later reversed its earlier decision and recommended Lucentis be covered under provincial health care systems drug formularies, paving the way for other Canadian provinces to provide coverage for the macular degeneration drug.  Even while recommending coverage for this eye disease drug, the CDR recognized that Lucentis could potentially cost provincial health care systems millions of dollars and limited the number of Lucentis treatments for the eye disease wet macular degeneration to 15 vials to treat the “better seeing eye”.

While Lucentis had demonstrated its effectiveness at stabalizing vision and in some cases improving vision in those patients suffering from macular degeneration, it is an extremely expensive drug, costing approximately $1,600 per treatment with each vial of the drug providing six Lucentis injections.  With some macular degeneration patients requiring monthly Lucentis injections for an indefinite period of time, the impact on provincial government sysetms could be dramatic.

Currently in Canada, coverage for Lucentis for wet macular degeneration is provided in Ontario and Quebec.

In listing Lucentis as part of the ODB formulary, the Ontario Ministry of Health and Long-Term care is establishing Ontario as one of the few provincial governments covering the drug for macular degeneration.  However, the ODB has established limits and criteria to aid eye care professionals to use in determining whether or not the Lucentis treatment for patients suffering from the eye disease wet macular degeneration.

Those people diagnosed with the eye disease who are residents of Ontario and have a valid Ontario Health Insurance (OHIP) are eligible for Lucentis coverage under the ODB program.  The criteria for determining coverage include the following criteria:

• people 65 years of age and older
• residents of long-term care facilities
• residents of Homes for Special Care
• people receiving professional services under the Home Care program; and
• Trillium Drug Program recipients

Additionally, residents of Ontario receiving social assistance (Ontario works or Ontario Disability Support Program Assistance) is eligible for ODB coverage for the drug Lucentis.  More detailed information regarding Ontario’s coverage of Lucentis for wet macular degeneration can be found on the Ontario Health Ministry Website or on the CNIB website. (requires Adobe Acrobat Reader)

Ontario’s move to provide coverage for Lucentis for wet macular degeneration has been applauded by eye care organizations throughout the province.  It is also hoped that other provincial governments across Canada will follow suit, especially since this drug was recommended by the Common Drug Review Committee.

Those seniors and elderly who qualify for coverage will no longer have to worry about losing their site to the eye disease macular degeneration and will no longer have to be concerned with having to seek alternate treatments for their eye care.

By recommending the drug Lucentis, the CDR has sent a message to the provincial health authorities across Canada.  With this recommendation to cover the cost of Lucentis, Canadians diagnosed with the leading cause of age related vision loss, wet macular degeneration (AMD), are one step closer today to real hope for vision improvement.

The Common Drug Review (CDR), Canada’s national drug review process, has recommended today that provincial drug plans list the innovative treatment Lucentis (ranibizumab) as a treatment for macular degeneration. The positive CDR recommendation for Lucentis is a critical step forward.

The Common Drug Review (CDR) recommended today that provincial drug plans across Canada should cover the cost of the drug Lucentis.  Lucentis is a drug produced by Genentech and is used to cover wet macular degeneration.  In making the recommendation to the provinces, the CDR recommended limiting treatments of Lucentis to 15 vials to treat the “better seeing eye”.

While Lucentis was approved by Health Canada in the Fall of 2007 as a treatment for wet macular degeneration, provincial health care authorities were slow to provide funding.  However, shortly after Lucentis’ approval by Health Canada, Quebec added coverage to its provincial drug plan and Ontario followed suit in early 2008.

Lucentis has been shown to be very effective in stabilizing and even improving sight in some patients that suffer from the wet form of age-related macular degeneration.  However this drug costs approximately $1,600 per injection and requires monthly injections indefinitely.  Each vial of Lucentis contains enough Lucentis for six injections.

Up until the approval of Lucentis, doctors in Canada were using Avastin (a colorectal cancer drug) in treating wet macular degeneration.  This use was considered “off-label” and was not covered under any provincial drug plans.  However, Avastin costs only a fraction when compared to Lucentis and is considered as effective as the approved drug.

This recommendation clearly sends a message to the provincial authorities:  it is time to provide a viable and insured mechanism to treat age-related macular degeneration, one of the leading causes of vision loss among older Canadians.  With Lucentis being the leading drug to treat age-related macular degeneration, it makes sense to provide coverage across Canada.

Lucentis is currently funded in the provinces of Ontario and Quebec.

April 2009 Update

Lucentis is now covered in the the following provinces:

• Newfoundland and Labrador
• Quebec
• Ontario
• Sasketchewan
• British Columbia

Please consult your local health care authority for details in these provinces as each have criteria and conditions for providing funding for Lucentis treatments for macular degeneration.