A newly approved ophthalmic formulation of bevacizumab is raising questions about how repurposed drugs should be priced, with researchers proposing a lower cost range than current expectations in a study published in The European Journal of Health Economics.
Bevacizumab, originally developed as the cancer drug Avastin®, has been widely used off-label for retinal diseases such as wet age-related macular degeneration due to its similar mechanism to other anti-vascular endothelial growth factor therapies and its far lower cost. Despite the availability of approved alternatives priced at over €500 to €700 per injection, off-label bevacizumab has remained widely used in clinical practice at a fraction of the price.
That landscape shifted in 2024 with the European Medicines Agency approval of Lytenava, a formulation developed specifically for ophthalmic use. However, its reported UK price of around £470 per injection (single-use vial) has raised concerns about affordability and the future of low-cost off-label use.
In response, researchers developed a cost-based pricing framework to estimate a sustainable price range for repurposed bevacizumab. The model incorporates key cost components—including manufacturing, regulatory requirements, and capital costs—alongside profit margins.
Their findings suggest a price range of €73 to €177 per injection, assuming typical treatment schedules. Across multiple scenarios, manufacturing costs and patient population size emerged as the primary drivers of price, while research and development costs contributed relatively little.
The results also highlight a gap between the modelled cost-based price and current list prices. Even under higher-cost assumptions, the estimated price remained substantially below the reported list price for Lytenava, highlighting potential implications for pricing discussions between manufacturers and healthcare payers.
While repurposed therapies are generally less costly to develop and benefit from existing safety data, the study notes that current pricing dynamics can discourage investment or, conversely, result in high prices that burden healthcare systems.
The researchers argue that greater transparency in cost structures could support more balanced pricing discussions. By clearly outlining how different cost components contribute to the final price, such models may help align commercial incentives with affordability — an important consideration in the context of drug repurposing.
The findings highlight the need for pricing models that reflect the lower development costs of repurposed drugs while maintaining incentives for innovation.
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