Blue Shield of California will soon stop covering bevacizumab for the treatment of metastatic breast cancer.
The coverage decision, which goes into effect on Oct. 17, comes a few months after the Food and Drug Administration’s Oncologic Drugs Advisory Committee recommended that the agency withdraw its approval of bevacizumab (Avastin) when used in combination with paclitaxel chemotherapy for first-line HER2-negative metastatic breast cancer, concluding that the treatment was not safe or effective.
The FDA commissioner has not made a final decision about whether to withdraw bevacizumab’s approval for metastatic breast cancer.
Blue Shield of California, which insures about 3.3 million Californians, will consider paying for bevacizumab for the treatment metastatic breast cancer on a "case-by-case basis," the company wrote in its updated coverage policy. They will also continue to cover the drug for women who are already being treated with it. The decision will not affect the insurer’s coverage of other indications of bevacizumab.
Blue Shield of California is not the first health plan to suspend coverage of bevacizumab, but it is the largest. Earlier this year, three regional insurers dropped coverage for bevacizumab for metastatic breast cancer. However, the Centers for Medicare and Medicaid Services continues to offer coverage through Medicare.
Charlotte Arnold, a spokeswoman for bevacizumab’s manufacturer, Genentech, said health plans should continue to cover the drug since it is still FDA approved and recommended for use under guidelines from the National Comprehensive Cancer Network. "We continue to believe that women with this incurable disease should have the ability to choose Avastin as an option if they and their doctor believe it’s the right option for them," she said.