Bevacizumab in recurrent, persistent, or advanced stage carcinoma of the cervix: Is it cost-effective?

Academic Article

Abstract

  • Objective. Evaluate the cost-effectiveness of incorporating bevacizumab into the treatment regimen for recurrent, persistent, or advanced stage carcinoma of the cervix following publication of a recent phase III trial that demonstrated an overall survival (OS) benefit with the addition of bevacizumab. Methods. A cost-effectiveness decision model was constructed using recently published results from a Gynecologic Oncology Group phase III study, comparing a standard chemotherapy regimen (Chemo) to the experimental regimen (Chemo + Bev) consisting of the standard regimen + bevacizumab. Costs and adverse events were incorporated and sensitivity analyses assessed model uncertainties. Results. The cost of Chemo + Bev was $53,784 compared to $5,688 for the Chemo arm. The 3.7 month OS advantage with Chemo + Bev came at an incremental cost-effectiveness ratio (ICER) of $155K per quality-adjusted life year (QALY). Chemo + Bev becomes cost-effective with an ICER ≤ $100K in sensitivity analysis when the cost of bevacizumab is discounted >37.5% or the dose is reduced from 15 to 7.5 mg/kg, an effective dose in ovarian cancer. Conclusions. With an ICER of $155K/QALY, the addition of bevacizumab to standard chemotherapy approaches common cost-effectiveness standards. Moderately discounting the cost of bevacizumab or using a smaller dose significantly alters its affordability.
  • Published In

    Digital Object Identifier (doi)

    Author List

  • Phippen NT; Leath CA; Havrilesky LJ; Barnett JC
  • Start Page

  • 43
  • End Page

  • 47
  • Volume

  • 136
  • Issue

  • 1