PMID- 27246689
OWN - NLM
STAT- MEDLINE
DCOM- 20171005
LR  - 20180917
IS  - 1935-469X (Electronic)
IS  - 1554-7477 (Linking)
VI  - 12
IP  - 7
DP  - 2016 Jul
TI  - Is FDA-Approved Bevacizumab Cost-Effective When Included in the Treatment of 
      Platinum-Resistant Recurrent Ovarian Cancer?
PG  - e775-83
LID - 10.1200/JOP.2015.010470 [doi]
AB  - PURPOSE: Although the Food and Drug Administration has approved incorporation of 
      bevacizumab (BEV) into the treatment of platinum-resistant ovarian cancer (PROC), 
      cost-value measures are an essential consideration, as evidenced by the recent 
      ASCO Value Framework initiative. We assessed the cost-effectiveness and reviewed 
      the net health benefit (NHB) of this expensive treatment. METHODS: A 
      cost-effectiveness decision model was constructed using results from a phase III 
      trial comparing BEV plus cytotoxic chemotherapy with chemotherapy alone in 
      patients with PROC. The Avastin Use in Platinum-Resistant Epithelial Ovarian 
      Cancer (AURELIA) trial demonstrated improvement in progression-free survival and 
      quality of life in patients receiving BEV. Costs, paracentesis rates, and adverse 
      events were incorporated, including subgroup analysis of different partner 
      chemotherapy agents. RESULTS: Inclusion of BEV in the treatment of 
      platinum-resistant recurrent ovarian cancer meets the common willingness-to-pay 
      incremental cost-effectiveness ratio (ICER) threshold of $100,000 per 
      progression-free life-year saved (LYS) for 15-mg/kg dosing and approaches this 
      threshold for 10-mg/kg dosing, with an ICER of $160,000. In sensitivity analysis, 
      reducing the cost of BEV by 13% (from $9,338 to $8,100 per cycle) allows 10-mg/kg 
      dosing to reach a $100,000 ICER. Exploratory analysis of different BEV 
      chemotherapy partners showed an ICER of $76,000 per progression-free LYS 
      (6.5-month progression-free survival improvement) and $54,000 per LYS (9.1-month 
      overall survival improvement) for the addition of BEV to paclitaxel once per 
      week. Using the ASCO framework for value assessment, the NHB score for BEV plus 
      paclitaxel once per week is 48. CONCLUSION: Using a willingness-to-pay threshold 
      of $100,000 ICER, the addition of BEV to chemotherapy either demonstrates or 
      approaches cost-effectiveness and NHB when added to the treatment of patients 
      with PROC.
CI  - Copyright (c) 2016 by American Society of Clinical Oncology.
FAU - Chappell, Nicole P
AU  - Chappell NP
AD  - San Antonio Military Medical Center, Fort Sam Houston, TX nicpchappell@gmail.com.
FAU - Miller, Caela R
AU  - Miller CR
AD  - San Antonio Military Medical Center, Fort Sam Houston, TX.
FAU - Fielden, Aaron D
AU  - Fielden AD
AD  - San Antonio Military Medical Center, Fort Sam Houston, TX.
FAU - Barnett, Jason C
AU  - Barnett JC
AD  - San Antonio Military Medical Center, Fort Sam Houston, TX.
LA  - eng
PT  - Journal Article
DEP - 20160531
PL  - United States
TA  - J Oncol Pract
JT  - Journal of oncology practice
JID - 101261852
RN  - 0 (Angiogenesis Inhibitors)
RN  - 0 (Organoplatinum Compounds)
RN  - 2S9ZZM9Q9V (Bevacizumab)
SB  - IM
MH  - Angiogenesis Inhibitors/adverse effects/*economics/therapeutic use
MH  - Bevacizumab/adverse effects/*economics/therapeutic use
MH  - Cost-Benefit Analysis
MH  - Decision Trees
MH  - Drug Approval
MH  - Drug Resistance, Neoplasm
MH  - Female
MH  - Humans
MH  - Neoplasm Recurrence, Local/drug therapy/*economics
MH  - Organoplatinum Compounds/therapeutic use
MH  - Ovarian Neoplasms/drug therapy/*economics
MH  - United States
MH  - United States Food and Drug Administration
EDAT- 2016/06/02 06:00
MHDA- 2017/10/06 06:00
CRDT- 2016/06/02 06:00
PHST- 2016/06/02 06:00 [entrez]
PHST- 2016/06/02 06:00 [pubmed]
PHST- 2017/10/06 06:00 [medline]
AID - JOP.2015.010470 [pii]
AID - 10.1200/JOP.2015.010470 [doi]
PST - ppublish
SO  - J Oncol Pract. 2016 Jul;12(7):e775-83. doi: 10.1200/JOP.2015.010470. Epub 2016 
      May 31.