Chicago, IL—The cost-effectiveness of adding bevacizumab (Avastin) to first-line chemotherapy for the treatment of metastatic colorectal cancer is comparable to that of many other therapies for metastatic cancer.
Although the acquisition cost of bevacizumab is high, it has improved the cost-effectiveness of systemic therapy (irinotecan [Camptosar]- or oxaliplatin-based regimens), said the study’s lead investigator, Diego Villa, MD, MPH, of the British Columbia Cancer Agency, Vancouver, Canada. He presented the results at the 2010 ASCO meeting.
Adding bevacizumab to chemotherapy has previously been shown to significantly improve overall survival in metastatic colorectal cancer, but “the cost of therapy with bevacizumab for advanced colorectal cancer is $44,000 to $55,000 per patient over 10 months of treatment,” Dr Villa said.
Dr Villa performed a population-based analysis using a Markov model that tracked major clinical and treatment events in the natural history of the disease. He compared outcomes and costs in the pre-bevacizumab era with those in the bevacizumab era. The database was comprised of patients with newly diagnosed metastatic colorectal cancer between 2003 and 2004 (pre-bevacizumab era) and 2006 (bevacizumab era) who were referred to the British Columbia Cancer Agency. Of the 943 patients included, 611 were from the pre-bevacizumab era and 332 were from the bevacizumab era.
When considering the costs associated with diagnosis and staging; surgery; systemic therapy; and radiation therapy, the weighted average cost of treatment per patient increased from $34,972 in the pre-bevacizumab era to $38,764 after bevacizumab was introduced.
Median overall survival for patients initiating chemotherapy improved from 15.6 months in the pre-bevacizumab era to 19.5 months in the bevacizumab era.
The cost-effectiveness ratio of bevacizumab for this indication was calculated at $15,617 per life-year gained, or $62,468 per quality-adjusted life-year gained, which is “in line with many other therapies for metastatic cancer,” Dr Villa noted.
