Diffusion of Bevacizumab Across Oncology Practices: An Observational Study

Area of Science:

• Oncology
• Health Services Research
• Pharmacoeconomics

Background:

• Technological advancements drive healthcare spending, necessitating understanding of new oncology therapy adoption.
• Bevacizumab (a novel biologic cancer therapy) adoption and cost are key concerns in oncology practice.

Purpose of the Study:

• To examine the diffusion of bevacizumab among US oncology practices from 2005-2012.
• To assess practice-level variations in bevacizumab use, including higher-value versus lower-value indications.

Main Methods:

• Population-based observational study utilizing a random sample of Medicare beneficiaries (2004-2012).
• Analysis of 2329 US practices providing cancer chemotherapy.
• Hierarchical models with practice random effects to assess bevacizumab use variation and associated factors.

Main Results:

• Bevacizumab diffused relatively quickly, with faster adoption in independent and larger oncology practices.
• Substantial variation in bevacizumab use was observed across practices (OR=2.90).
• Variation was more pronounced for lower-value uses (OR=3.61) compared to higher-value uses (OR=2.72).

Conclusions:

• Bevacizumab use demonstrated wide variation across oncology practices, particularly for lower-value indications.
• Targeted practice-based interventions show promise for reducing low-value use of high-cost cancer therapies.