Replacing ranibizumab with bevacizumab on the Pharmaceutical Benefits Scheme: where does the current evidence leave us?

The battle between two anti-vascular endothelial growth factor (VEGF) treatment options (ranibizumab and bevacizumab) for neovascular macular degeneration is a topic of particular significance to eye health professionals with an interest in cost-effective treatment. Being the first of its kind directly comparing the two anti-VEGF, a recent large multicentre clinical trial has shown that bevacizumab is not inferior when compared with ranibizumab in regards to efficacy of visual acuity outcomes; the evidence at this stage is inconclusive for safety outcomes. Before bevacizumab can be considered a justifiable replacement for the much more expensive ranibizumab on the Pharmaceutical Benefits Scheme (PBS), its safety in treatment needs further supporting evidence.