The Current Funding Landscape of Bevacizumab (Avastin) As Front-Line Treatment for Advanced Ovarian Cancer: A Health Economics Dilemma |Biomedgrid

Ovarian cancer is the most common cause of death in women with gynecologic malignancies [1]. Until recently, standard treatment in the front-line setting consists of combination chemotherapy with debulking surgery [2]. Despite optimal upfront therapy, the estimated 5-year overall survival is approximately 40% and prognosis is much worse for those with stage IV disease or other high-risk features [3]. Systemic therapy for ovarian has been evolving in the past decade with the emergence of targeted therapy, such as Avastin (bevacizumab), a monoclonal antibody targeting vascular endothelial growth factor, currently manufactured by the pharmaceutical company Hoffman-La Roche. It has shown promising activity and survival benefit in several large randomized clinical trials of women with high-risk advanced ovarian cancer [4,5], leading to FDA approval of this drug in the front-line setting and representing a new standard treatment option for this disease. However, cost-effectiveness analyses have shown conflicting results, with many studies suggesting this may not be a costeffective intervention, particularly in jurisdictions such as Canada, where a public health care system is in place [6-10].