After pressure from Congress, the Centers for Medicare and Medicaid has accelerated its recently announced changes to reimbursement coding for Avastin, which is used to treat wet macular degeneration, a leading cause of blindness among seniors. The drug, however, is controversial because it’s often used off-label in small amounts to treat the eye disease.

Why? Avastin is made by Genentech, which also sells Lucentis, a more expensive drug approved by the FDA to combat the same problem. But anywhere from 50 percent to 60 percent of docs use Avastin instead of Lucentis, because it costs $2,000 a dose versus about $50 for Avastin.

Last month, the CMS agreed to reinstate its original billing rate for Avastin. However, the agency was going to wait until Jan. 1 to make the change. However, the CMS put those changes into effect last week, according to a source familiar with the issue. This is a big deal for opthalmologists and retinal surgeons, who have already used Avastin and were holding onto their reimbursement billings.

The change in the payment code could have prompted docs to switch to Lucentis, which upset Herb Kohl of the Senate Aging Committee, because the higher-priced Lucentis may have cost Medicare an extra $3 billion or so a year and forced seniors to make additional copayments.