One-year results from the first head-to-head study of Genentech's VEGF-binding monoclonal antibody (mAb) Avastin (bevacizumab) show it is as effective in treating neovascular age-related macular degeneration (AMD) as Genentech's much more expensive Lucentis (ranibizumab). For years, Avastin, a cancer drug, has been used off-label to treat AMD (Nat. Biotechnol. 26, 867–875, 2008). But Genentech, a subsidiary of Basel-based Roche, never conducted clinical studies with Avastin in AMD, instead developing Lucentis, (an antigen-binding fragment derived from the same mAb as Avastin). Lucentis is approved by the US Food and Drug Administration for AMD and costs ∼$2,000 per dose, whereas the price of Avastin reformulated for this indication is about $50. The Comparison of AMD Treatments Trials (CATT) evaluated the outcomes in 1,208 people with neovascular AMD assigned to one of the treatments. “At one year, Lucentis and Avastin were equivalent for visual acuity at all time points when administered at the same dosing regimen,” Daniel Martin, CATT study chair and chairman of the Cole Eye Institute at the Cleveland Clinic, told reporters. “In our study we clearly show equivalence between the two drugs.” The study revealed no difference in the rates of death, myocardial infarction and stroke. “Regulators in certain countries will be forced to reconsider their policies that make it illegal to use drugs off-label,” Philip Rosenfeld of the Bascom Palmer Eye Institute of the University of Miami wrote in an editorial accompanying the publication of CATT in The New England Journal of Medicine. “The CATT data support the continued global use of intravitreal bevacizumab as an effective, low-cost alternative to ranibizumab.”