Avastin is already losing insurer support in breast cancer, even without a revoked indication from the FDA. Blue Shield of California said it would no longer pay for the Roche drug as a breast cancer treatment, beginning Oct. 17. The 3.3 million-member health plan cited an FDA advisory panel's June vote to yank Avastin's approval for that use.
Blue Shield joins a short list of insurers who've backed away from Avastin's use in breast cancer. It is, as the New York Times reports, the first large insurer to do so. "We agreed with the FDA panel," Stephen M. Shivinsky, a spokesman for Blue Shield, told the newspaper.
The move follows months of debate about Avastin's utility for breast cancer patients, an often emotional controversy that culminated in the June appeal hearing. Patients begged FDA's expert advisors to keep Avastin's breast cancer indication, while doctors and patient groups have come down on both sides of the issue. The FDA first moved to pull the indication in December 2010; it has yet to issue a final decision.
Among the other health plans that have also decided against paying for Avastin as a breast cancer treatment are BlueCross BlueShield plans in the northwestern U.S. and Excellus BlueCross BlueShield in Rochester, NY, the NYT reports. These plans pulled Avastin reimbursement for that use before the June meeting but after FDA's first move to revoke the indication, a spokesman for Roche's U.S unit, Genentech, told the Times.
Avastin prescriptions for breast-cancer patients have already dropped, the Chicago Tribune reports. Avastin was once prescribed to 60% of eligible patients--now, it's more like 20%, the newspaper says.
Roche has asked FDA to keep Avastin's breast cancer indication, particularly for women with the fewest treatment alternatives and the most aggressive forms of the disease, to give it time to wrap up another clinical trial. The company has also been searching for a biomarker that might identify breast cancer patients most likely to benefit from Avastin treatment. The drug is also approved to treat colon and other cancers.