Avastin versus Lucentis

Drug treatment for age related macular degeneration is one of medicine’s success stories. As Ning Cheung and colleagues explain (doi:10.1136/bmj.e2970), anti-vascular endothelial growth factors are preserving and restoring vision to millions around the world. But a related and less edifying story is stealing the limelight: ranibuzimab (Lucentis) versus bevacizumab (Avastin). It casts a shadow over this great medical advance and puts the world’s drug development and licensing systems under the spotlight.

In its anti-cancer drug, bevacizumab, drug developer Genentech has created what may be the world’s first “not me” (as opposed to “me too”) drug, say Robert Campbell and colleagues (doi:10.1136/bmj.e2941). Despite evidence that it works in macular …