The Burrill Report


Blue Shield of California will require all new requests to treat breast cancer with Genentech’s Avastin to be reviewed and found medically necessary by a panel of oncology experts before covering the therapy.

The policy change, effective October 17, comes about three months after an FDA advisory panel voted to support the agency’s decision to remove breast cancer from Avastin’s list of approved indications. The vote came after the panel reviewed data from new studies that showed that use of the drug did not extend the lives of breast cancer patients.

Blue Shield of California will continue to provide coverage to women taking Avastin for breast cancer. But a panel of oncology experts will review new requests for coverage, says Steve Shivinsky, a spokesman for the company. The drug remains approved for use in treating lung, kidney, and brain cancers.

The FDA granted the drug a conditional approval for treating breast cancer in February 2008 as part of a program intended to allow earlier patient access to drugs for serious or life-threatening conditions while further research is done to back their safety and efficacy. But after several studies failed to support its use, the agency moved to strike the breast cancer indication from Avastin’s label.

Despite that decision, the use of Avastin for breast cancer therapy has retained support in other quarters. The National Comprehensive Cancer Network, an alliance of leading cancer centers, reaffirmed in July its recommendation for the use of Avastin in metastatic breast cancer; and some women, who believe the drug has helped them, have continued to speak out against the label change.

With 3.3 million members, Blue Shield of California is a member of the BlueCross BlueShield Association, the United States’ largest collective of benefits companies, serving a nearly one third of Americans.


October 06, 2011
http://www.burrillreport.com/article-avastin_loses_insurer_support_in_california.html