FDA ruling against Avastin wouldn't deter half of doctors

What to do while waiting for the FDA to issue its final word on Avastin's breast cancer indication? Divine what happens next, of course. Reading the tea leaves on Avastin's future as a breast cancer treatment is a growing pastime, and a new survey of doctors fits right into the trend.

Published in the journal Cancer, the survey shows that oncologists' opinions about the Roche drug are about as split as U.S. voters' viewpoints on the 2012 elections. Almost half of the respondents in the small survey say they'll continue using Avastin for breast cancer, at least under certain circumstances, regardless of the FDA's decision. On the flip side, a fifth said they wouldn't use it at all, and 9% more said they'd be reluctant to do so.

Payers are all over the place on Avastin, too, as Reuters points out. A few major insurers have already cut coverage for Avastin in breast cancer, while Medicare officials say they'll cover it no matter what the FDA does. If the agency decides to revoke the indication, more insurers will weigh in with their own coverage decisions, and the payers' choices would obviously affect physicians' ability to prescribe the drug.

Amid considerable angst, an FDA advisory panel voted in favor of pulling Avastin's breast cancer indication, based on follow-up studies showing the drug was not as effective at prolonging patients' lives as initially thought. Commissioner Margaret Hamburg is expected to announce a final decision on the indication soon. Roche has asked the FDA to keep the indication--at least for the sickest patients and for those with the fewest treatment alternatives--while it conducts more studies.

- see the study abstract
- read the Reuters story

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