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The cost of bevacizumab
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The title of the editorial says it all: "Big costs for little gain in ovarian cancer?" This study, reported in the Journal of Clinical Oncology, looked at the cost of adding bevacizumab to frontline treatment for ovarian cancer using the Gynecology Oncology Group (GOG) trial 218 ). Bevacizumab (including maintenance bevacizumab) extended progression-free survival by almost 4 months, but at quite a cost. The authors estimate that the addition of bevacizumab costs $78.3 million! And when adjusted for the ICER, or incremental cost effectiveness ratio, costs $401,088 per progression-free year of life. It is generally accepted that an intervention is cost-effective when it has an ICER of $50 to $100,000 or less, so this is clearly well beyond that mark. The authors were also able to estimate that to reach that "cost effectiveness," progression-free survival would need to reach 32.1 months, or bevacizumab would need to cost 75% less than it does currently. The authors of the editorial go on to discuss what the implications (or lack of implications) are for this study. In essence, who cares about this? And they say it better than I could when they state, "Buying bevacizumab ... for 600 women means not buying something else, such as basic clinical research to find better compounds that improve overall survival by a meaningful magnitude." Amen to that! But I am left to wonder: Do you think anyone is listening? Do patients and providers really care about the incremental cost of another biologic anti-cancer agent?