Blue Shield of California Discontinues Coverage for Avastin for Breast Cancer

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After an FDA panel decision that declared the drug bevacizumab (Avastin) ineffective and potentially unsafe, Blue Cross of California has announced that it will no longer provide coverage for the drug when it is used to treat breast cancer. It is the largest insurer to do so, and it is expected that others will follow suit.

Other health insurance companies that have discontinued coverage of Avastin include Regence, which has 2.5 million members in Idaho, Oregon, Utah and Washington, and Excellus, with 1.9 million members in Rochester NY. A third insurer called Dakotacare, located in South Dakota, has also dropped coverage for the drug when used for breast cancer.

So far, Medicare will continue to pay for bevacizumab, says a spokesman for the Centers for Medicare and Medicaid Services (CMS).
In June, the Oncologic Drugs Advisory Committee voted 6-0 that bevacizumab, an $8,000-a-month drug marketed by Genentech, should no longer be approved to treat locally recurrent or metastatic HER2-negative breast cancer because it offers no significant improvement in progression-free survival, no difference in overall survival, and that it has a poor safety profile, including hypertension, bleeding and an increased risk of toxicity.

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The drug will remain on the market because it is also approved to treat metastatic colon cancer, metastatic non-squamous non-small cell lung cancer, metastatic renal cell carcinoma, and glioblastoma multiforme.

"We are very disappointed by the committee's recommendation and hope the Commissioner (FDA Commissioner Margaret Hamburg MD) does not decide to remove this important medicine for women with an incurable disease who already have too few treatment options," said Hal Barron, MD, chief medical officer and head of Global Product Development for Genentech, in a statement.

"We believe insurers should cover Avastin for this use, and women with this incurable disease should have the ability to choose Avastin if they, and their doctor, believe it's the right option for them," said Genentech spokeswoman Charlotte Arnold in an email.

Blue Shield of California will discontinue coverage effective October 17, 2011.

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