OBJECTIVES: The study aims to systematically review the effectiveness, safety and cost-effectiveness of bevacizumab treatment for advanced non-small cell lung cancer in China.

METHODS: A systematic review method was performed. Both national and international clinical, quality of life and cost-effectiveness studies were collected mainly from database of Cochrane, Pubmed, EMBASE, CNKI, etc., since 2010.

RESULTS: With inclusion and exclusion criteria, there were seven meta-analysis studies on clinical efficacy and safety, two studies on quality of life, three pharmacoeconomic systematic review and four cost-effectiveness studies finally recruited for the analysis. Clinical results demonstrated that chemotherapy-based bevacizumab-regimen was effective, well tolerated and no deterioration in quality of life. Compared with chemotherapy-alone, bevacizumab-regimen substantially improved overall-survival (HR 0.91; 95%CI 0.83-1.00; p=0.039), progression-free-survival (HR 0.69; 95%CI 0.61-0.79; p<0.001), objective-response-rate (RR 1.80; 95%CI 1.52-2.13; p<0.001) and disease-control-rate (RR 1.34; 95%CI 1.21-1.48; p<0.001). The pharmacoeconomic studies showed that from the perspective of Italy, Korean, Taiwan and Poland payers, ICERs of bevacizumab-regimen versus chemotherapy ranged from USD23,822/LY to USD 54,317/LY. The ICERs were below the local acceptable threshold, and bevacizumab-regimen was considered as a cost-effective treatment option. While the ICERs of bevacizumab-regimen versus chemotherapy were higher in USA, ranging between USD 308,982/LY and USD337,179/LY, far beyond USD50,000/QALY threshold. Heterogeneous in terms of dosage, drug-price, cost category existed in published studies.

CONCLUSIONS: Chemotherapy-based bevacizumab-regimen can be considered as a new standard option for advanced non-small lung cancer patients. However, more evidences on cost-effectiveness of bevacizumab are still needed to support local public decision making on health insurance benefits update in China. Additionally, in the era of personalized healthcare, it is suggested to explore new methods and dimensions to evaluate the economic value of oncology drugs for complementary.