Blue Shield of California To End Coverage of Avastin for Breast Cancer
Blue Shield of California no longer will pay for the drug Avastin for treatment of breast cancer, making the company the first large health insurer to end coverage for the drug, the New York Times reports.
Blue Shield, which has 3.2 million members, announced on its website that reimbursement would end Oct. 17 but that it would consider exceptions on case-by-case basis.
Stephen Shivinsky -- a spokesperson for Blue Shield -- said the insurer would continue to pay for Avastin for those who already are using it (Pollack, New York Times, 10/2).
The drug was approved in 2008 for treatment of breast cancer.
In June, an FDA advisory committee recommended that the agency rescind approval of Avastin to treat breast cancer because the drug did not significantly benefit patients and had negative side effects (Erman, Reuters, 10/2).
FDA Commissioner Margaret Hamburg has yet to make a final decision on the matter.
Because Avastin is approved to treat other types of cancer, it would remain on the market if FDA rescinds its approval for use against breast cancer, and physicians still could prescribe the drug for the disease.
Meanwhile, Medicare has indicated that it will continue to pay for the drug to treat breast cancer even if FDA revokes its approval, while many other insurers have said they will wait to decide until the agency makes a final announcement.
Some doctors and patients have said insurers would be less likely to pay for Avastin for off-label use, which could be cost prohibitive for some women. The drug costs about $88,000 annually.
Edward Lang -- a spokesperson for drugmaker Genentech, which sells Avastin -- said he is aware of three other insurers that have decided not to pay for the drug:
- Regence, which operates Blue Shield plans in the Northwest;
- Excellus BlueCross BlueShield in Rochester, N.Y.; and
- Dakotacare in South Dakota.
He noted that Genentech "believe[s] women should have access to the medicine and that insurers should cover it" (New York Times, 10/2).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.