Compounding pharmacies can no longer buy bevacizumab (Avastin) from their wholesalers. This is the result of a decision by the manufacturer Genentech to limit the sale of the drug starting Nov. 30. Compounding pharmacies have been preparing the cancer drug in small doses on an off-label basis to treat patients with macular degeneration. But Genentech contends that the compounded preparations may be contaminated and, besides, patients can now use its ranibizumab (Lucentis) for their condition. However, ranibizumab costs about $2,000 a dose as opposed to $50 for bevacizumab. Genentech said doctors can still buy bevacizumab and then send the drug to pharmacies for compounding. Ophthalmologists don't like this decision since it's an extra step they must take.

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