First-Line Bevacizumab for Glioblastoma Not Likely To Be Cost-Effective

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Bevacizumab has only limited effectiveness and is therefore not likely to be cost effective in treating adult patients with newly diagnosed glioblastoma multiforme, a new study published online in the Journal of Clinical Oncology has shown.

For the cost-effectiveness analysis, researchers from St Joseph's Healthcare Hamilton in Ontario, Canada, developed a Markov model to estimate the incremental cost-utility ratio (ICUR) of first-line bevacizumab in newly diagnosed glioblastoma multiforme from a Canadian public payer perspective.

Results of the analysis showed that over a 2-year time horizon, the addition of bevacizumab to radiotherapy and temozolomide resulted in an increase of 0.13 QALYs and $80,000 per patient, corresponding to an ICUR of $607,966/QALY (95% CI: $305,000/QALY to $2,550,000/QALY). The researchers found that at the $100,000/QALY willingness-to-pay threshold, bevacizumab had a 0% chance of being cost-effective.

The researchers note that second-line treatment with bevacizumab is more effective on progression and less expensive than first-line bevacizumab. The findings suggest that further research is unnecessary.

As newer treatment options for peritoneal carcinomatosis are developed, more clinical data is needed
Bevacizumab has limited effectiveness and is therefore not likely to be cost effective in newly diagnosed glioblastoma multiforme.
The Avastin in Glioblastoma trial has shown that patients newly diagnosed with glioblastoma multiforme (GBM) treated with bevacizumab plus radiotherapy (RT) and temozolomide versus RT and temozolomide alone showed improvement in PFS, possibly leading to a new indication for first-line use of bevacizumab in GBM.

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