Genentech reinvigorates vision as biotech resource for patients, physicians

July 15, 2008

John Snisarenko, vice president of sales and marketing for Lucentis, outlines in an interview with Ophthalmology Times how Genentech Inc. is working to improve its relationship with the ophthalmic community as well as offer assistance to physicians and patients in accessing ranibizumab.

Key Points

John Snisarenko, vice president of sales and marketing for Lucentis (ranibizumab), discussed in an interview with Ophthalmology Times how Genentech is working to improve its relationship with the ophthalmic community and provide assistance to physicians and patients in accessing ranibizumab.

Genentech has learned from the bevacizumab experience, he said. Overall, relationships and communications with the ophthalmic community have improved since the AAO meeting. Genentech is consulting with the leadership of AAO and the American Society of Retina Specialists (ASRS) about upcoming initiatives, and they are working together as partners.

"We're also working with [ASRS] on distribution initiatives as well as [obtaining] their counsel before we launch some of [those] initiatives," he said. "Moving forward, this is the way we want to work together."

Snisarenko said he understands that it takes time to regain the trust of the physicians and to rebuild relationships. He added that it would take sustained actions from Genentech's perspective.

"Over time, [physicians] will realize that we are making an effort to understand their practices and their needs and [are] working with their leadership to be able to work more in partnership," he said.

Role of ranibizumab

When it comes to treating wet age-related macular degeneration (AMD), Genentech believes that ranibizumab is a vital therapy over bevacizumab in terms of fulfilling an unmet medical need. Snisarenko reiterated the company's position that ranibizumab has been through various clinical trials and is approved by the FDA for ophthalmic use.

"It's got the safety profile," he said. "We also want to make sure that we don't take the choice away from retina physicians. They have the opportunity to use whatever product they see fit. We truly believe that [ranibizumab] is the key product for wet AMD and also for future indications."

In the company's efforts to diffuse the pricing argument surrounding ranibizumab, Genentech has enhanced its patient and physician support programs, including its Lucentis Access Solutions and Genentech Access to Care Foundation programs (See "Programs designed to provide greater access for patients, physicians,"). Since 1985, Genentech reportedly has donated more than $1 billion worth of medication in all of its therapeutic areas. The company's philosophy is that patients should not be denied access to drugs based on affordability or price.

Another initiative program that Genentech offers is Lucentis Direct. Designed as an option to its existing distribution network, the program does not replace wholesale distributors but rather offers retina surgeons an option to order directly from Genentech.

"What we're offering is a live call center and the ability to ship to multiple addresses," Snisarenko said. "[Physicians] have been asking to speak directly with Genentech."

Ranibizumab also is expected to play a major role in the company's commitment to ophthalmic research and development (R&D).

From a short-term perspective, Snisarenko said, more research is being conducted in the arena of wet AMD by developing ways to optimize dosing with ranibizumab and to determine how the drug can best be used to treat patients and enhance outcomes.

Genentech also is researching ways to expand ranibizumab to treat other retinal diseases, such as diabetic macular edema (DME) and retinal vein occlusion. The company has four phase III clinical trials (two in each disease state) in the pipeline, with more than 300 patients enrolled in each trial. Updates were presented at the annual meeting of the Association for Research in Vision and Ophthalmology in May.

Long-term, Genentech is researching ways to deliver ranibizumab via a sustained-release mechanism so patients may not require monthly treatments.

"It's part of our early development program . . . but we have seen that optimizing dosing is a key parameter with wet AMD, in terms of compliance [and patients] coming in every month," Snisarenko said. "If we come up with a longer-acting [ranibizumab] down the road, it will help both patients and physician practices."

Although ranibizumab has shown success in the ophthalmic market, he said the company has made a strong commitment to developing other drugs for undeveloped areas of eye disease.