Novartis and Roche are in a $251-million bind over allegations from Italy’s antitrust agency that accuses the companies of conspiring to keep Avastin sales at bay to ease the entry of their higher-priced Lucentis in the wet age-related macular degeneration market.

Reuters reports that the companies say they did not agree to restrict competition and will appeal the verdict. According to Reuters, Italy’s agency claims the companies presented Avastin as a dangerous alternative to Lucentis.

The alleged positioning is not limited to the Mediterranean: the Washington Post reported in December that Genentech, which is owned by Roche, has helped nudge doctors toward Lucentis through various means, which include packaging Avastin in quantities that make it difficult to break down into smaller eye-friendly doses without risking contamination. The WaPo also noted that reimbursement rates also make doctors more amenable to Lucentis prescriptions because the higher cost results in a higher reimbursement rate.