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Inhibitors of vascular endothelial growth factor — bevacizumab (Avastin) and ranibizumab (Lucentis) — are used to treat patients with neovascular age-related macular degeneration. Bevacizumab is FDA-approved for cancer treatment and is prescribed off-label for neovascular age-related macular degeneration, whereas ranibizumab was specifically developed and approved for this indication. Because the drugs differ dramatically in cost per dose — about US$50 for bevacizumab versus $2000 for ranibizumab, usually given monthly — the need for a head-to-head comparison has been obvious.
NIH-sponsored investigators randomized patients to intravitreal injections of bevacizumab or ranibizumab, each administered monthly or as needed. Visual acuity outcome…