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Avastin v. Lucentis: An Early Test Case For Medicare ACOs

Executive Summary

Medicare costs for covering Genentech's Lucentis for wet age-related macular degeneration will get heightened scrutiny now that a widely anticipated National Institutes of Health trial has confirmed that much-less-expensive treatment with the company's Avastin is as effective. Based on 2008 claims data, Medicare is spending about $500 million more on Lucentis than Avastin for treatment of wet AMD.

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