title: Barriers to the Access of Bevacizumab in Patients with Solid Tumors and the Potential Impact of Biosimilars: A Physician Survey.
abstract: Access to bevacizumab, an important component of oncology treatment regimens, may be limited. This survey of oncologists in the US (n= 150), Europe (n= 230), and emerging markets (EM: Brazil, Mexico, and Turkey;n= 130) examined use of and barriers to accessing bevacizumab as treatment of advanced solid tumors. We also assessed the likelihood that physicians would prescribe a bevacizumab biosimilar, if available. Bevacizumab was frequently used as early-line therapy in metastatic colorectal cancer, metastatic non-squamous non-small-cell lung cancer, and metastatic ovarian cancer (all markets), and as a second-line therapy in glioblastoma multiforme (US, EM). A greater percentage of EM-based physicians cited access-related issues as a barrier to prescribing bevacizumab versus US and EU physicians. Lack of reimbursement and high out-of-pocket costs were cited as predominant barriers to prescribing and common reasons for reducing the number of planned cycles. Overall, ~50% of physicians reported they "definitely" or "probably" would prescribe a bevacizumab biosimilar, if available. Efficacy and safety data in specific tumor types and lower cost were factors cited that would increase likelihood to prescribe a bevacizumab biosimilar. A lower cost bevacizumab biosimilar could address the unmet needs of patients and physicians worldwide, and may have the greatest impact on patient outcomes in EM.
authors.affiliation: Arizona Oncology (US Oncology Network), University of Arizona, College of Medicine, Creighton University School of Medicine at St. Joseph's Hospital, 2222 E. Highland Ave., Suite 400, Phoenix, AZ 85016, USA. Bradley.Monk@usoncology.com.
authors.forename: Bradley J
authors.initials: BJ
authors.lastname: Monk
authors.affiliation: Meharry Medical College, 1005 Dr. D.B. Todd Jr. Blvd., Nashville, TN 37208-3501, USA. plammers@mmc.edu.
authors.forename: Philip E
authors.initials: PE
authors.lastname: Lammers
authors.affiliation: Florida Cancer Affiliates, 433 SW 10th Street, Ocala, FL 34471, USA. thomas.cartwright@usoncology.com.
authors.forename: Thomas
authors.initials: T
authors.lastname: Cartwright
authors.affiliation: Pfizer Inc, 235 East 42nd Street, New York, NY 10017-5755, USA. ira.jacobs@pfizer.com.
authors.forename: Ira
authors.initials: I
authors.lastname: Jacobs
keywords: access to health care; bevacizumab; biosimilars; colorectal cancer; non–small-cell lung cancer; ovarian cancer