Literature DB >> 26060224

How Do Payers Respond to Regulatory Actions? The Case of Bevacizumab.

Stacie B Dusetzina1, Shellie Ellis2, Rachel A Freedman2, Rena M Conti2, Aaron N Winn2, James D Chambers2, G Caleb Alexander2, Haiden A Huskamp2, Nancy L Keating2.   

Abstract

PURPOSE: In February 2008, the US Food and Drug Administration (FDA) granted accelerated approval for bevacizumab for metastatic breast cancer. After public hearings in July 2010, and June 2011, the FDA revoked this approved indication in November 2011, on the basis of additional evidence regarding its risk/benefit profile. The Centers for Medicare and Medicaid Services, local Medicare contractors, and commercial payers varied in their stated intentions to cover bevacizumab after FDA's regulatory actions. We examined payer-specific trends in bevacizumab use after the FDA's regulatory actions.
METHODS: We used outpatient medical claims compiled by IMS Health to evaluate trends in bevacizumab use for breast cancer for Medicare-insured and commercially insured patients (N = 102,906) using segmented regression. Given that Medicare coverage policies may vary across regional contractors, we estimated trends in bevacizumab use across 10 local coverage areas. In a sensitivity analysis, we estimated trends in bevacizumab use for breast cancer compared with trends in use for lung cancer using difference-in-differences models.
RESULTS: Among chemotherapy infusions for breast cancer, bevacizumab use decreased from 31% in July 2010, to 4% in September 2012. Use decreased by 11% among commercially insured and 13% among Medicare-insured patients after July 2010 (interaction P = .68) and continued to decline by 9% per month (interaction P = .61). We observed no contractor-level variation in bevacizumab use among Medicare beneficiaries. During the same period, bevacizumab use for lung cancer was stable.
CONCLUSION: Although insurers varied in public statements regarding coverage intentions, bevacizumab use declined similarly among all payers, suggesting that provider decision making, rather than payer-specific coverage policies, drove reductions.
Copyright © 2015 by American Society of Clinical Oncology.

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Year:  2015        PMID: 26060224      PMCID: PMC4507391          DOI: 10.1200/JOP.2015.004218

Source DB:  PubMed          Journal:  J Oncol Pract        ISSN: 1554-7477            Impact factor:   3.840


  22 in total

1.  The impact of Medicare coverage policies on health care utilization.

Authors:  Susan Bartlett Foote; Beth A Virnig; Robert J Town; Lacey Hartman
Journal:  Health Serv Res       Date:  2008-05-12       Impact factor: 3.402

Review 2.  Impact of FDA drug risk communications on health care utilization and health behaviors: a systematic review.

Authors:  Stacie B Dusetzina; Ashley S Higashi; E Ray Dorsey; Rena Conti; Haiden A Huskamp; Shu Zhu; Craig F Garfield; G Caleb Alexander
Journal:  Med Care       Date:  2012-06       Impact factor: 2.983

3.  Optimal first-line and maintenance treatments for advanced-stage nonsquamous non-small cell lung cancer.

Authors:  Ryan D Gentzler; Jyoti D Patel
Journal:  J Natl Compr Canc Netw       Date:  2014-06       Impact factor: 11.908

4.  Decline in the use of anthracyclines for breast cancer.

Authors:  Sharon H Giordano; Yu-Li Lin; Yong Fang Kuo; Gabriel N Hortobagyi; James S Goodwin
Journal:  J Clin Oncol       Date:  2012-05-21       Impact factor: 44.544

5.  Trends in co-prescribing of antidepressants and tamoxifen among women with breast cancer, 2004-2010.

Authors:  Stacie B Dusetzina; G Caleb Alexander; Rachel A Freedman; Haiden A Huskamp; Nancy L Keating
Journal:  Breast Cancer Res Treat       Date:  2012-11-13       Impact factor: 4.872

6.  Geographic variation in physicians' responses to a reimbursement change.

Authors:  Mireille Jacobson; Craig C Earle; Joseph P Newhouse
Journal:  N Engl J Med       Date:  2011-11-02       Impact factor: 91.245

7.  Phase III study of bevacizumab plus docetaxel compared with placebo plus docetaxel for the first-line treatment of human epidermal growth factor receptor 2-negative metastatic breast cancer.

Authors:  David W Miles; Arlene Chan; Luc Y Dirix; Javier Cortés; Xavier Pivot; Piotr Tomczak; Thierry Delozier; Joo Hyuk Sohn; Louise Provencher; Fabio Puglisi; Nadia Harbeck; Guenther G Steger; Andreas Schneeweiss; Andrew M Wardley; Andreas Chlistalla; Gilles Romieu
Journal:  J Clin Oncol       Date:  2010-05-24       Impact factor: 44.544

8.  The impact of emerging safety and effectiveness evidence on the use of physician-administered drugs: the case of bevacizumab for breast cancer.

Authors:  Rena M Conti; Stacie B Dusetzina; Ann C Herbert; Ernst R Berndt; Haiden A Huskamp; Nancy L Keating
Journal:  Med Care       Date:  2013-07       Impact factor: 2.983

9.  FDA drug approval summary: bevacizumab (Avastin) as treatment of recurrent glioblastoma multiforme.

Authors:  Martin H Cohen; Yuan Li Shen; Patricia Keegan; Richard Pazdur
Journal:  Oncologist       Date:  2009-11-06

10.  FDA drug approval summary: bevacizumab plus interferon for advanced renal cell carcinoma.

Authors:  Jeff Summers; Martin H Cohen; Patricia Keegan; Richard Pazdur
Journal:  Oncologist       Date:  2010-01-08
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