Doctors across America have been saving sight using an injectable drug that slows the formation of new blood vessels under the retina, helping people suffering from wet age-related macular degeneration and proliferative diabetic retinopathy regain vision loss.

Lucentis and its chemically similar cousin Avastin developed by San Francisco-based Genentech are proven to be both safe and effective treatments.

What is Avastin?

Avastin is an eye medication designed to slow vision loss among those suffering from wet age-related macular degeneration. By blocking the vascular endothelial growth factor (VEGF), Avastin prevents abnormal vessel growth and leakage that damages macula, helping restore central vision while decreasing macular scarring for improved retina function.

Lucentis, which acts as a VEGF inhibitor, can be an effective treatment for wet AMD; however, its side effects include stroke, heart attack or liver failure. Each injection costs over $2,000 while Medicare typically pays 20 percent of its full price which adds up over time. A new study suggests that an alternative to Lucentis with significantly less cost might just as effective at treating wet macular degeneration.

The FDA has also approved various other anti-VEGF drugs to treat neovascular age-related macular degeneration, including ranibizumab (Lucentis), aflibercept (Eylea), and brolucizumab-dbll (Beovu, or Vabysmo) – approved originally to treat cancer but often prescribed off-label to patients suffering from wet AMD as they are much cheaper alternatives compared to systemic anti-VEGF agents specifically formulated for eye care use.

Before administering an injection, your eye doctor will use pain-relieving drops to numb your eye, before administering an avastin injection directly into the white portion of your eyeball (known as the sclera). The process only takes 15-20 seconds and most patients do not experience any pain during or following it. He or she may use a device or contact lens protection afterward as well.

Avastin and Lucentis share many chemical similarities, both containing bevacizumab as their active ingredient; initially developed to treat cancer but now also used to help protect macular degeneration patients against blindness. Lucentis was specifically designed to penetrate eye vessels while Avastin is often prescribed at higher doses than its dose used for eye injections.

How Does Avastin Work?

Avastin and Lucentis, two injection-type eye medicines, can be injected directly into the eye to block new blood vessels from growing or leaking in a disease called neovascular age-related macular degeneration, which affects the macula of the retina which allows people to see fine details clearly. As the condition advances, patients may notice straight lines becoming crooked or wavy and central vision may blur or distort over time. According to the National Eye Institute’s guidelines, adults over 60 should undergo screening exams by an ophthalmologist annually or sooner should risk factors exist for developing risk factors for such diseases.

Both medications work by blocking vascular endothelial growth factor (VEGF), a protein which promotes new blood vessel formation in the eye. Both drugs must be injected monthly into each eye, with Avastin being cheaper due to being derived from cancer medication that has already been widely prescribed at much higher dosages for treating cancer patients.

Like Lucentis, both medications have proven their ability to effectively improve vision in patients suffering from neovascular AMD. According to one study, patients treated with one drug improved their reading abilities by an average of eight letters after one year – similar to what Lucentis patients saw.

Both drugs are administered using the same procedure: slowly injecting a small amount of liquid into one eye while applying steady pressure at the injection site, followed by withdrawing the needle while checking that no fluid refluxes into the vitreous. Patients should be warned during injection that they may experience discomfort or experience the sensation of floating particles in their affected eye.

Researchers recently conducted a trial which demonstrated that both bevacizumab (Avastin) and ranibizumab (Lucentis) are equally effective at improving vision for patients suffering from wet age-related macular degeneration. Participants with initial vision 20/50 or worse were randomly assigned either Avastin or Lucentis; groups receiving Avastin showed similar visual improvements while those taking both drugs on an as-needed basis (PRN) saw greater gains.

What Are the Side Effects of Avastin?

Avastin (bevacizumab) has been approved to treat several cancers, as well as treating wet form of age-related macular degeneration. Avastin works by inhibiting abnormal blood vessel growth associated with this eye condition which involves leakage from retinal blood vessels resulting in leakage of fluid into retinal areas of vision loss. As a result, fluid accumulates beneath the retinal tissue resulting in visual loss. Since Avastin is significantly cheaper than Lucentis (ranibizumab), which has been FDA-approved to treat macular degeneration, doctors often utilize it “off-label” for macular degeneration treatment. Avastin is a large molecule designed to reach retinal blood vessels through intravitreal injection. Genentech initially thought its molecule might be too big, but doctors have discovered it can reach this area via intravitreal injection.

Studies comparing Lucentis and Avastin for treating wet macular degeneration showed similar effectiveness; however, Avastin proved more cost-effective for many patients due to being significantly cheaper; furthermore it also has reduced risks such as stroke and heart attack than its counterpart.

The National Eye Institute funded this study that compared Lucentis and Avastin among 1,200 patients suffering from wet macular degeneration. Results indicated that those receiving monthly Avastin injections could read an average of 8 more letters on an eye chart by year’s end than those on Lucentis; these findings align with results seen from prior trials comparing anti-VEGF drugs against one another.

Chronic diabetic macular edema (DME) can be challenging to treat with anti-VEGF drugs alone. Researchers from Indiana University School of Medicine and Midwest Eye Institute in Indianapolis conducted a new study comparing monthly intravitreal injections of Avastin with quarterly injections of Ozurdex injections as treatment options for persistent DME. At study’s conclusion, best corrected visual acuity and central subfield thickness had equaled between the groups; with Ozurdex significantly decreasing central subfield thickness nine times faster while also increasing intraocular pressure more.

The FDA recently added a warning label to Avastin regarding rare cases of reversible posterior leukoencephalopathy syndrome. Genentech reported seven such instances through post-market surveillance and is working on developing an anti-angiogenic drug with smaller molecular structures that will penetrate more easily into eye tissue.

How Much Does Avastin Cost?

Avastin, the generic version of bevacizumab, is used to treat eye diseases. The FDA has approved Avastin’s use in order to delay or improve vision loss due to wet macular degeneration or diabetic macular edema; and to restore vision loss due to these conditions. Avastin works by blocking the action of VEGF protein which encourages blood vessel formation that leaks behind the eye causing swelling in this part of the eye.

Genentech, which manufactures Avastin, invested millions into creating Lucentis as a macular degeneration treatment and funding its clinical trials that proved its safety and efficacy, yet says they have no plans to spend any funds researching whether their cheaper drug, Avastin, is equally effective against macular degeneration and other eye conditions.

Researchers recently conducted a study which demonstrated that Avastin was just as effective as Lucentis in protecting and improving vision in elderly individuals with an eye disease that causes swelling of their retina to form fluid pockets at the back of the eye. This research was funded by Medicare and conducted at University of Miami Medical School in Florida.

Findings indicate that Avastin could be the more cost-effective choice, though other studies must validate these results and it may work differently or have different side effects than its more costly competitor.

Anti-VEGF medicines such as ranibizumab (Lucentis), aflibercept (Eylea) and brolucizumab (Beosmo) are available to treat wet macular degeneration and diabetic maculopathy, including the more expensive treatments like ranibizumab (Lucentis), aflibercept (Eylea) and brolucizumab (Beosmo). According to recent research, all three are equally effective at improving vision in DME patients; two year data have shown aflibercept being superior over bevacizumab in subset of patients. Avastin remains the most frequently prescribed treatment worldwide while its price difference between it and more expensive medications doesn’t justify significant increases in price differences for Avastin which would make other treatments competitive with this one.