Adding Bevacizumab To Single-Agent Chemotherapy For The Treatment Of Platinum-Resistant Recurrent Ovarian Cancer: A Cost-Effectiveness Analysis Of The Aurelia Trial

Em, Schaffer; Coles, T.M.; Wysham, Weiya Z.; Roque,; Kh, Kim; Wheeler, SB

doi:10.1016/j.jval.2015.09.1193

Cited by 2 publications

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“…Using the results of the AURELIA trial, a conference abstract was recently published in which a decision-tree-based cost-effectiveness analysis was undertaken from a US public payer perspective [ 20 ]. This study reported an ICER of $US285,624 per QALY gained over a 15-month time horizon.…”

Section: Discussionmentioning

confidence: 99%

Economic Evaluation of Bevacizumab for Treatment of Platinum-Resistant Recurrent Ovarian Cancer in Canada

Ball

Xie

Tarride

2017

PharmacoEconomics Open

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BackgroundOvarian cancer is a leading cause of cancer-related mortality. Although the disease is relatively rare, it carries a disproportionately large morbidity burden.ObjectiveWe conducted a cost-utility analysis from a Canadian public payer perspective to determine the cost effectiveness of bevacizumab, a newly available treatment option for recurrent ovarian cancer.MethodsUsing a 7-year time horizon, a three health-state cohort-based partitioned survival model was developed to assess the cost utility of bevacizumab plus chemotherapy (BEV) versus chemotherapy alone. We reconstructed individual patient data from published Kaplan–Meier curves. Clinical parameters, including progression-free survival and overall survival, were derived from the AURELIA phase III randomized controlled trial. Costs, resource utilization and utility values from recent Canadian sources were used to populate the model. Results were presented using incremental cost-utility ratios (ICURs). Uncertainty was examined through univariate and probabilistic sensitivity analyses.ResultsThe reconstructed individual patient data matched the AURELIA trial results. Total costs for the BEV and chemotherapy treatment arms were $Can79,086 and $Can54,982, respectively. Total estimated quality-adjusted life-years (QALYs) were 1.1055 and 0.9926 for the BEV and chemotherapy arms, respectively. The ICUR was estimated to be $Can213,424 per QALY gained. At a willingness-to-pay threshold of $Can100,000 per QALY gained, the probability of BEV being cost effective was 0.ConclusionsThe results of our analysis suggest that the addition of bevacizumab to single-agent chemotherapy treatment, while improving patient outcomes, is unlikely to be cost effective in this Canadian patient population. The results also provide some preliminary validation for use of individual patient data-reconstruction techniques in pharmacoeconomic evaluation.Electronic supplementary materialThe online version of this article (doi:10.1007/s41669-017-0030-7) contains supplementary material, which is available to authorized users.

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Section: Discussionmentioning

confidence: 99%