A Prospective Cost-Utility Analysis of Bevacizumab-Based Combination Therapy Versus Chemotherapy Alone in Ovarian Cancer

Background

Ovarian cancer remains a leading cause of gynaecologic cancer mortality globally. While chemotherapy is the standard treatment, the addition of targeted therapies such as bevacizumab may improve clinical outcomes. However, the economic burden and quality-of-life impact of these regimens remain insufficiently explored. This study compared the cost-utility and Quality-Adjusted Life Years (QALYs) of chemotherapy alone versus bevacizumab-based combination therapy in ovarian cancer patients.

Materials and Methods

This prospective pharmacoeconomic study was conducted over six months at a tertiary care hospital and included 110 ovarian cancer patients. Participants received either chemotherapy alone (n=61) or combination therapy (n=49). Data were obtained from patient case records and quality-of-life questionnaires; QALYs were calculated using utility scores. Direct medical costs were used for cost-utility analysis.

Results

Mean total treatment cost was INR 87,365.17±35,460.39 for chemotherapy and INR 5,44,413.11±1,43,754.25 for combination therapy. QALYs were 2.47 (chemotherapy) and 2.68 (combination therapy). The Incremental Cost-Utility Ratio (ICUR) for combination therapy was INR 21,88,200.99 per QALY, exceeding the Willingness-To-Pay (WTP) threshold of INR 2,00,000 per QALY.

Conclusion

Although combination therapy yielded marginally higher QALYs and better quality-of-life outcomes, its substantially higher cost limits cost-effectiveness within the current Indian healthcare context. Chemotherapy alone remained cost-effective at the defined WTP threshold.