Bevacizumab (Avastin) in Breast Cancer — Neither Effective nor Cost-Effective

It’s been well documented that bevacizumab is not very effective in breast cancer.

However, Roche/Genentech continues to lobby it’s use for this indication. At the ASCO 2011 meeting there was yet another study documenting the lack of efficacy and value of the drug in breast cancer. Needless to say there were no company hyped headlines touting the results.

The study from Singapore found:

Bevacizumab added 0.49 years of PFS and 0.135 QALY with an incremental cost of $100,300 and therefore a cost of $204,000 per year of PFS gained and an ICER of $745,000 per QALY.

PFS= progression free survival
QALY= quality adjusted life year
ICER= the additional cost per one life year gained of one treatment over another

Medicynical note: Three reasons why bevacizumab should not be used in breast cancer. High costs, lack of benefits and additional toxicity.

The numbers are embarrassing. $745,000 for an additional life year (ICER). A statistical gain of just .135 life years (QALY).

If Genentech/Roche were to price the drug at 1/10 the current price it would be marginally cost effective, while remaining ineffective in extending life. It’s amazing that there is still a discussion about this indication.