Roche's Avastin: Four More Months Of Life Worth The Cost?

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Main Category: Ovarian Cancer
Article Date: 09 Mar 2011 - 1:00 PDT

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Many prescription medications issued to treat potentially fatal ovarian cancer in women are quite expensive. Now in a recent study, Roche's Avastin (bevacizumab) is being called into question and analyzed for its worth.

Bevacizumab is a novel targeted therapy designed to inhibit angiogenesis, the process by which new blood vessels develop and carry vital nutrients to a tumor. It has been shown to extend lives by an average of 3.8 months in ovarian cancer patients, but researchers question if the price companies are charging is actually "worth it."

Dr. David E. Cohn, a gynecologic surgical oncologist and researcher at The Ohio State University Comprehensive Cancer Center Arthur G. James Cancer Hospital and Richard J. Solove Research Institute stated:

"We do not suggest that bevacizumab, also known by the brand name Avastin, should be withheld from a patient with ovarian cancer, but rather argue that studies evaluating the effectiveness of new treatments should also be interpreted with consideration of the expense. We put together a model looking at the variety of treatment arms on this clinical trial, each of which included 600 patients. Given the fact that the addition of the drug was associated with 3.8 months of additional survival without cancer, we set out to determine whether or not that benefit of survival was justified by the expense of the drug."

The model showed that standard chemotherapy for patients in the clinical trial would cost $2.5 million, compared to $78.3 million for patients who were treated with standard chemotherapy and bevacizumab, plus additional maintenance treatments of bevacizumab for almost one year.

Researchers from Ohio State University performed a cost-effectiveness analysis looking at a clinical trial conducted by the Gynecologic Oncology Group (GOG) studying the use of bevacizumab along with standard chemotherapy for patients with advanced ovarian cancer.

Although a discussion regarding cost-effectiveness of a potentially life-extending intervention invariably suggests the rationing of limited health care resources, the intent of this study was to provide a framework with which to evaluate the pending results of a clinical trial of three different interventions for ovarian cancer.

Bevacizumab is currently used to battle ovarian cancer and approved by the U.S. Food and Drug Administration (FDA) for cancers that are metastatic (have spread to other parts of the body). It received its first approval in 2004 for combination use with standard chemotherapy for metastatic colon cancer and non-small cell lung cancer. In 2008, it was approved by the FDA for use in metastatic breast cancer, a decision that generated some controversy as it went against the recommendation of its advisory panel, who objected because it only slowed tumor growth but failed to extend survival. In the US, Members of a Food and Drug Administration panel said in July 2010 that they do not see enough of a benefit from Avastin in advanced breast cancer to justify its serious risks.

Cohn continues:

"Ultimately, we found that if you reduced the drug cost to 25 percent of the baseline, it does become cost effective to treat patients with bevacizumab. Or, if the survival could be substantially increased above the 3.8 months of progression-free survival, that could lead to cost-effective treatment for patients with advanced ovarian cancer."

Typically each treatment with bevacizumab costs $5,000, with most of those costs directly attributable to the cost of the drug, Cohn said. Ovarian cancer is the most lethal gynecologic cancer, with almost 14,000 women expected to die from the disease this year, according to the American Cancer Society.

Finally, Cohn concludes:

"It is anticipated that in the future, there will be increased scrutiny regarding the individual and societal costs of an effective medication. We hope that future clinical trials will incorporate the prospective collection of cost, toxicity and quality-of-life data to allow for a fully informed interpretation of the results."

Have a look at The Ohio State University release and Dr. Cohn video HERE.

Written by Sy Kraft, B.A.


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