This week’s HND piece explores a phenomenon that is more widespread than most people think. For starters, some estimates peg the extent of this practice at around 20 percent of all prescriptions written.
Not to make too fine a point of it, but since the use is off-label, by definition, there is little if any conventional scientific validation of these drug indications. Of course, given the state of science these days, as well as the politics of drug approvals, some of the best-selling FDA-approved drugs don’t have much science behind them, either.
For the most part, off-label use is based on plenty of anecdotal evidence that such practices are safe and effective—unless the off-label use is strictly driven by cost. Sadly, that is definitely the case regarding the off-label use of Avastin®—a cancer drug—instead of Lucentis®, for the treatment of neovascular (wet) age-related macular degeneration. Lucentis carries an FDA approval for this indication, and Avastin does not.