Avastin: Worth the Cost?

Implications: Avastin improves survival in colon cancer and lung cancer and improves progression free survival in breast cancer- clinically meaningful outcomes.  Yet these gains are of relatively short duration and the cost of Avastin is significant- 50,000 to 100,000 dollars per year.

Analysis: Avastin is an important drug, tolerable for most patients, and improves outcomes significantly in colon, lung and breast cancer.  However, the gains are relatively modest and the cost can be considered excessive.  For now, I offer this drug to my patients as a standard of care, recongnizing the modest gaines and the extreme cost.  However, patients also need to be aware that this is not a miracle drug but rather another agent in our armamentarium that improves outcomes but does not offer cure to patients with metastatic disease.