Al's Comment:

 This is one of the biggest problems we have - the high cost of treatments.  This analysis found a small benefit to adding bevacizumab (Avastin) to Temodar for people with inoperable Glioblastomas.  However, because of the high cost of the drug, it was determined that is not cost effective.  They set the acceptability bar at $26,500 to add 1 year of life. This treatment worked out to $171,638 for each year of life added. Not even close.  

 This is a societal problem. I do not blame the drug companies, as the cost to develop a drug under our system is so high that to recoup their investment, the prices have to be high.  Without high prices, there would not be new drugs getting approved.  We need to change the system so that any researcher with a good idea could afford to bring a drug through the system to get approval - which not only will drastically lower the cost of new drugs but gives us a wider range of treatments to use.

Posted on: 01/04/2020

Oncol Lett. 2020 Jan;19(1):424-430. doi: 10.3892/ol.2019.11099. Epub 2019 Nov 14.
Cost-effectiveness analysis of the addition of bevacizumab to temozolomide therapy for the treatment of unresected glioblastoma.
Chen Z1, Zhan M1, Tian F1, Xu T1.
Author information:
1. Department of Pharmacy, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P.R. China.
Glioblastoma, a cancer that originates from astrocytes, is the most prevalent malignant glioma in the adult population. The aim of the present study was to evaluate the cost-effectiveness of bevacizumab (BEV) as a supplement to standard temozolomide (TMZ) treatment for unresected glioblastoma. The analyzed data were from a phase II trial that showed a survival benefit following combination therapy, when compared with TMZ monotherapy. According to the clinical symptoms and disease progression, a Markov model was constructed to estimate the incremental cost-effectiveness ratio (ICER) from a Chinese societal perspective. Health outcomes were retrieved from the GENOM 009 trial, and utility parameters were obtained from published literature. Uncertainties within the model were addressed through one-way deterministic and probabilistic sensitivity analyses. The addition of BEV to TMZ therapy increased overall costs by $30,894.99, with a gain of 0.18 quality-adjusted life-years (QALYs), resulting in an ICER of $171,638.83/QALY. Both one-way sensitivity and probabilistic sensitivity analyses confirmed that BEV/TMZ co-treatment was not cost-effective in the context of a $26,508.00/QALY willingness-to-pay (WTP) threshold. The utility of the progression-free survival state had the most noticeable impact on the ICER. In summary, the combination of BEV and TMZ should not be considered a cost-effective neoadjuvant treatment option for patients with unresected glioblastoma in China, from a societal perspective. However, in view of the survival benefits conferred, an appropriate price discount or the use of medical insurance could make BEV affordable for this patient population.
Copyright: © Chen et al.
PMCID: PMC6924092
PMID: 31897155 


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