Today, the New York Times reports on a secret rebate program that Genentech is using to apparently encourage doctors to prescribe Lucentis for macular degeneration instead of the less costly Avastin. The program, which started on 1 October, could potentially earn tens of thousands of dollars for participating practitioners. Lucentis, which recent studies have shown performs no better than Avastin at treating vision loss, costs about $2,000 per dose. Avastin, which was originally developed by Genentech to treat colon and lung cancers, costs less than $100 per dose.

The Times article says that Genentech is trying to spin the program as an effort to encourage doctors to prescribe Lucentis for retinal vein occlusion, a condition which the US Food and Drug Administration (FDA) approved the drug for in June. But the company has been investigated for Avastin-related chicanery before. In 2007, Herb Kohl, a US Senator from Wisconsin, asked the FDA to look into whether or not Genentech was artificially limiting the availability of Avastin to ophthalmologists to force them to prescribe the more expensive alternative.

While the (still unknown) details of the Lucentis rebate program may be contorted enough to not meet the legal definition of bribery, if it looks and walks like the proverbial duck, most people will be hard-pressed to call it a goose. And Genentech’s explanation for the program sounds all too much like quacking, particularly because recent studies have hinted that Avastin works to treat retinal vein occlusion.

Image by Karen Roe via Flickr Creative Commons