Bevacizumab in treatment of high-risk ovarian cancer--a cost-effectiveness analysis.

Abstract

The objective of this study was to evaluate a cost-effectiveness strategy of bevacizumab in a subset of high-risk advanced ovarian cancer patients with survival benefit. Methods. A subset analysis of the International Collaboration on Ovarian Neoplasms 7 trial showed that additions of bevacizumab (B) and maintenance bevacizumab (mB) to paclitaxel (P) and carboplatin (C) improved the overall survival (OS) of high-risk advanced cancer patients. Actual and estimated costs of treatment were determined from Medicare payment. Incremental cost-effectiveness ratio per life-year saved was established. Results. The estimated cost of PC is $535 per cycle; PCB + mB (7.5 mg/kg) is $3,760 per cycle for the first 6 cycles and then $3,225 per cycle for 12 mB cycles. Of 465 high-risk stage IIIC (>1 cm residual) or stage IV patients, the previously reported OS after PC was 28.8 months versus 36.6 months in those who underwent PCB + mB. With an estimated 8-month improvement in OS, the incremental cost-effectiveness ratio of B was $167,771 per life-year saved. Conclusion. In this clinically relevant subset of women with high-risk advanced ovarian cancer with overall survival benefit after bevacizumab, our economic model suggests that the incremental cost of bevacizumab was approximately $170,000.

• Authors: John K Chan, Thomas J Herzog, Lilian Hu, Bradley J Monk, Tuyen Kiet, Kevin Blansit, Daniel S Kapp, Xinhua Yu
• Journal: The oncologist (Oncologist) Vol. 19 Issue 5 Pg. 523-7 (May 2014) ISSN: 1549-490X [Electronic] England
• PMID: 24721817 (Publication Type: Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Angiogenesis Inhibitors
• Antibodies, Monoclonal, Humanized
• VEGFA protein, human
• Vascular Endothelial Growth Factor A
• Bevacizumab
• Carboplatin
• Paclitaxel

Topics

• Angiogenesis Inhibitors (adverse effects, economics, therapeutic use)
• Antibodies, Monoclonal, Humanized (adverse effects, economics, therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Bevacizumab
• Carboplatin (economics, therapeutic use)
• Carcinoma, Ovarian Epithelial
• Cost-Benefit Analysis
• Disease-Free Survival
• Female
• Health Care Costs
• Humans
• Middle Aged
• Models, Economic
• Neoplasms, Glandular and Epithelial (drug therapy, mortality)
• Ovarian Neoplasms (drug therapy, mortality)
• Paclitaxel (economics, therapeutic use)
• Quality of Life
• Vascular Endothelial Growth Factor A (antagonists & inhibitors)