Insurer to Cover New Use for Avastin

Insurance giant Empire Blue Cross & Blue Shield said Tuesday that it would pay for use of Genentech Inc.’s Avastin in some lung cancer patients after a large clinical trial showed the drug prolonged the lives of such patients.

Those who received Avastin plus chemotherapy in the clinical trial lived about 12.5 months, compared with 10.2 months in the chemotherapy-only group, according to the National Cancer Institute. The Food and Drug Administration approved Avastin last year, but only for treating colon cancer.

“We’re very impressed with this study,” said Karen Early, a spokeswoman for New York-based Empire Blue Cross & Blue Shield. “We will cover it in individual cases today based on the results of this study.”

Shares of South San Francisco-based Genentech, majority-owned by Roche Holding, fell 75 cents Tuesday to $54.25 on the New York Stock Exchange. But that follows a 25% surge Monday. Shares of New York-based WellChoice Inc., which owns Empire Blue Cross & Blue Shield, gained 5 cents to $52.09.

Insurers have been reluctant to pay for unapproved uses of Avastin because of its high price -- it costs $4,400 a month for colon cancer, and the dose is doubled for lung cancer, doctors and investors said.

Insurance coverage will be an initial factor in prescribing the drug, said Fairooz Kabbinavar, an oncologist at UCLA.

“The drug is already out there,” said Kabbinavar, who treats patients at UCLA’s Jonsson Comprehensive Cancer Center. “Insurance company coverage will be the important step in getting it to patients.”

Avastin is the only U.S. approved medicine that interferes with blood-vessel growth, a process called angiogenesis. The drug chokes off the blood supply that feeds tumors.

“There is a reluctance for people to pay for off-label use of therapies,” said Jason Dahl, a managing director at Victory Capital Management in New York. “A case-by-case basis is something I think we’ll see insurers look at increasingly, going forward.”

The medicine will probably have broad applications, said Leonard Saltz, a colon cancer specialist at Memorial Sloan-Kettering Cancer Center in New York.

Genentech is also testing the drug on breast, kidney, ovarian and pancreatic cancers.

“I’m optimistic that it should work against a lot of different types of cancer,” Saltz said. “It struck me as illogical that it would work in colon cancer and nothing else.”

Use of the drug will probably be limited until the FDA officially approves it for lung cancer patients, doctors and analysts said.

Genentech is planning to meet with the FDA to discuss approval for the new Avastin use, spokesman Neil Cohen said. He declined to say when the company might seek approval.