Policy Brief (Issue 15): Should high-cost bevacizumab be used for metastatic-colorectal cancer (mCRC) treatment in JKN in Indonesia?

Colorectal cancer is the third most common cancer in Indonesia with approximately 28,000 patients diagnosed each year. Without population-based screening, patients are often treated when they reach the advanced stage.

Bevacizumab, a newly available high-cost treatment for metastatic colorectal cancer (mCRC), is part of the National Drug Formulary and, thus, included in benefit package under the JKN, the universal health coverage (UHC) in Indonesia. Although it shows better effectiveness, it also has a significantly higher cost compared to chemotherapy alone.

This economic evaluation was conducted to assess the value for money and budget impact of using bevacizumab compared to chemotherapy alone. The findings reveal that adding bevacizumab to the existing chemotherapy should be reconsidered as it is not good value for money in Indonesian context. Taking out bevacizumab would imply a marginal loss to patients but would save significant budget to BPJS, the healthcare payer, for spending on other priority programs, such as early detection of colorectal cancer.