bevacizumab (Avastin)

Advice

following a full submission

bevacizumab (Avastin®) is not recommended for use within NHS Scotland.

Indication under review: bevacizumab in combination with capecitabine is indicated for first-line treatment of patients with metastatic breast cancer in whom treatment with other chemotherapy options including taxanes or anthracyclines is not considered appropriate. 

In a double-blind, multicentre, randomised, placebo-controlled phase III study in patients with locally recurrent or metastatic breast cancer, treatment with bevacizumab plus capecitabine was associated with an extended median progression-free survival of 2.9 months compared with capecitabine monotherapy. However, there was no overall significant improvement in survival.

The submitting company did not present a sufficiently robust economic analysis and, in addition, their justification of the treatment’s cost in relation to its health benefits was not sufficient to gain acceptance by the SMC.