• New York Times, Thursday, November 4, 2010 10:45 AM

Andrew Pollack breaks the story that Genentech, which is owned by the Swiss company Roche, has been offering secret rebates to eye doctors to use more of the company's Lucentis -- which is primarily used to treat macular degeneration -- rather than Avastin, a less costly drug it also manufactures.

Avastin is approved only to treat cancer but many retina specialists say it works just as well in the eye as Lucentis and they use it off label. Each Avastin injection costs only $20 to $50 as opposed to $2,000 for Lucentis.

Genentech says "rebate and discount programs are a common business practice across the industry, including in the field of ophthalmology." They are considered a form of volume discount, Pollack reports, and are legal if they adhere to certain guidelines. But some doctors he interviewed have ethical concerns about the arrangement. "There's no way to look at that without calling it bribery," says Dr. Greg Rosenthal.

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