Evidence map›Paper›PMID 25448456›Full record

ArticleGynecologic oncology2015

Bevacizumab in recurrent, persistent, or advanced stage carcinoma of the cervix: is it cost-effective?

Neil T Phippen, Charles A Leath, Laura J Havrilesky, Jason C Barnett

Abstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in Gynecologic oncology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 3 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 3 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

12 citing papers in PubMed, 3 syntheses or guidelines pooled it.

  1. Pooled it
  2. The cost of chemotherapy administration: a systematic review and meta-analysis.The European journal of health economics : HEPAC : health economics in prevention and care · 2021
    Pooled it
  3. Pooled it
  4. Article
  5. Article
  6. Article
  7. Review
  8. Estimation of the Costs of Invasive Cervical Cancer Treatment in Brazil: A Micro-Costing Study.Revista brasileira de ginecologia e obstetricia : revista da Federacao Brasileira das Sociedades de Ginecologia e Obstetricia · 2019
    Article
  9. Article
  10. [Progress on clinical application of bevacizumab for the treatment of refractory cervical cancer].Zhejiang da xue xue bao. Yi xue ban = Journal of Zhejiang University. Medical sciences · 2016
    Article
  11. Review
  12. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

Neil T PhippenGynecologic Oncology Service, Walter Reed National Military Medical Center, Room 3440, 3rd floor, Gyn Bldg 19, 8901 Wisconsin Ave, Bethesda, MD 20889, USA. Electronic address: neil.phippen@icloud.com.
Charles A LeathDivision of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Alabama School of Medicine, Room 10250, 1700 6th Avenue South, Birmingham, AL 35233, USA.
Laura J HavrileskyDivision of Gynecologic Oncology, Duke Cancer Center, 20 Duke Medicine Circle, Durham, NC 27710, USA.
Jason C BarnettDivision of Gynecologic Oncology, Department of OB/GYN, San Antonio Military Medical Center, 3551 Roger Brooke Drive, Fort Sam, Houston, TX 78234, USA.

Funding

Treatment of HIV- and HIV+ Patients with HPV16+ CIN2/3 Using pNGLV4a-hCRTE6E7L2 DNA vaccine administered intramuscularly via electroporationP50CA098252 · NCI · JOHNS HOPKINS UNIVERSITY · PI Richard Bruce Roden · 2003 to 2026
$53.5M
NCTN Deep South Research ConsortiumU10CA180855 · NCI · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI BJORNSTI, MARY-ANN, FALKSON, CARLA I · 2014 to 2018
$2.6M
NCI NIH HHS P50 CA098252NCI NIH HHS U10 CA180855
6 · The paper itself

Abstract

objectiveEvaluate the cost-effectiveness of incorporating bevacizumab into the treatment regimen for recurrent, persistent, or advanced stage carcinoma of the cervix following publication of a recent phase III trial that demonstrated an overall survival (OS) benefit with the addition of bevacizumab.

methodsA cost-effectiveness decision model was constructed using recently published results from a Gynecologic Oncology Group phase III study, comparing a standard chemotherapy regimen (Chemo) to the experimental regimen (Chemo + Bev) consisting of the standard regimen+bevacizumab. Costs and adverse events were incorporated and sensitivity analyses assessed model uncertainties.

resultsThe cost of Chemo + Bev was $53,784 compared to $5,688 for the Chemo arm. The 3.7 month OS advantage with Chemo+Bev came at an incremental cost-effectiveness ratio (ICER) of $155K per quality-adjusted life year (QALY). Chemo + Bev becomes cost-effective with an ICER ≤ $100K in sensitivity analysis when the cost of bevacizumab is discounted >37.5% or the dose is reduced from 15 to 7.5 mg/kg, an effective dose in ovarian cancer.

conclusionsWith an ICER of $155K/QALY, the addition of bevacizumab to standard chemotherapy approaches common cost-effectiveness standards. Moderately discounting the cost of bevacizumab or using a smaller dose significantly alters its affordability.

Indexed as

Antibodies, Monoclonal, HumanizedAntineoplastic Combined Chemotherapy ProtocolsBevacizumabCisplatinClinical Trials, Phase III as TopicCost-Benefit AnalysisDecision Support TechniquesFemaleHumansModels, EconomicPaclitaxelTopotecanUnited StatesUterine Cervical NeoplasmsAntibodies, Monoclonal, HumanizedBevacizumabCisplatinPaclitaxelTopotecanBevacizumabCervical cancerCost-effectiveness

Identifiers

PMID25448456
PMCPMC5553065

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.