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An Ethical View of the Ranibizumab and Bevacizumab Controversy—Reply
Raja Narayanan, MD;
Baruch D. Kuppermann, MD, PhD
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In reply
We appreciate the concerns expressed by Packer and Jampol regarding the costs of drugs and their associated RCTs and that it may not be possible to conduct an RCT in all situations. We agree that cost plays an important role, but it should not be an excuse to not conduct an RCT, especially in prevalent blinding disorders such as age-related macular degeneration. An RCT does not always have to be sponsored by a company. A few select centers across the United States and the rest of the world can conduct investigator-initiated trials with funding from various state, federal, and even nongovernmental agencies. The National Eye Institute–sponsored trial comparing bevacizumab and ranibizumab1 as well as the Macular Telangiectasia Project natural history study2 are examples of multicenter studies where the funding is being provided by state, federal, or nongovernmental organizations and the . . . [Full Text of this Article]
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