School of Public Health

Soledad Jorge

Use of Bevacizumab for Newly Diagnosed Ovarian Cancer: A National Analysis

Objective

To describe the use patterns and costs of bevacizumab (BEV) for the upfront treatment of ovarian cancer (OC) in the US.

Methods

We identified women ages 18 - 65 with newly diagnosed OC from 2008 to 2016 through the Truven Health MarketScan® database. Of these, women who underwent cancer-directed surgery and platinum-based chemotherapy within 6 months of diagnosis were included (N=8109). The proportion of women receiving BEV was calculated and multivariate logistic regression was used to determine factors associated with BEV use. Total costs per cycle of BEV were calculated.

Results

About 6.4% (N=522) of new OC cases received BEV within 6 months of diagnosis. Rates of BEV use increased 1.8-fold, from 4.1% (2008) to 7.4% (2016), with peak use in 2014 (8.5%). Patients receiving BEV were less likely than those not receiving BEV to be treated with a platinum/taxane doublet (46.4% v 90.4%) and more likely to be treated with platinum monotherapy (51.3% v 5.4%) (p<0.001). More recent year of diagnosis, younger age, presence of ascites or metastatic disease, treatment by a medical oncologist, and residing in the Southern US were associated with statistically higher odds of receiving BEV (p<0.01). The median cost of one cycle of BEV monotherapy was $6873 [IQR:$4,824–11,276] and the cost of one cycle of platinum/taxane/BEV was $ 10,897 [IQR:$7,573–18,133].

Conclusion

BEV use has increased over the years and is related to several clinical and non-clinical factors. BEV has been used with non-standard regimens (platinum/taxane) over half the time and its cost is highly variable.