Limited Cost Benefit of bevacizumab (Avastin) in Lung Cancer

From the ASCO Meetings:

Randomized, double-blind multicentre phase III study of bevacizumab in combination with cisplatin and gemcitabine in chemotherapy-naive patients with advanced or recurrent non-squamous non-small cell lung cancer (NSCLC): BO17704

In this study chemotherapy was compared with two dose levels of bevacizumab (Avastin), an anti-angiogenic agent, in lung cancer patients. Using chemotherapy alone (cisplatin and gemcitabine) progression free survival was 6.1 months. This compared with 6.7 months survival in the group who also received the lower dose of bevacizumab and 6.5 months in the group on the higher dose.

The results were reported to show a statistically significant “improvement” in survival. What is not reported is that the pricing of Avastin (bevacizumab) can be as high as $100,000/year.

There appears to be little or no cost sensitivity, or for matter cost awareness, in medical practice and research. This is one of the most important problems to be confronted as we move towards a national health system. Spending more than most people’s yearly salary or the cost of an automobile to achieve a few months additional survival does not seem reasonable.

What’s wrong with our system is that it’s not a system.

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