Cost-benefit Profile Research Articles

Comparison of Implant Precision with Robots, Navigation, or Static Guides

Comparison of Implant Precision with Robots, Navigation, or Static Guides

Diagnostic testing in psychiatry: insights and examples from a Bayesian perspective.

To demonstrate the application of Bayes' theorem to diagnostic testing in clinical settings, especially with respect to rare diseases, enhancing an understanding of pre-test probability and its implications. Bayes' theorem enables the revision of the conditional probabilities of an event occurring when new information is acquired. It demonstrates that when the prevalence of a disease is very low, there are a high number of false positives, thereby reducing the clinical utility and cost benefit profile of the diagnostic test, even in the presence of relatively high sensitivities and specificities of the chosen test.

Optimally generate policy-based evidence before scaling.

Social scientists have increasingly turned to the experimental method to understand human behaviour. One critical issue that makes solving social problems difficult is scaling up the idea from a small group to a larger group in more diverse situations. The urgency of scaling policies impacts us every day, whether it is protecting the health and safety of a community or enhancing the opportunities of future generations. Yet, a common result is that, when we scale up ideas, most experience a 'voltage drop'-that is, on scaling, the cost-benefit profile depreciates considerably. Here I argue that, to reduce voltage drops, we must optimally generate policy-based evidence. Optimality requires answering two crucial questions: what information should be generated and in what sequence. The economics underlying the science of scaling provides insights into these questions, which are in some cases at odds with conventional approaches. For example, there are important situations in which I advocate flipping the traditional social science research model to an approach that, from the beginning, produces the type of policy-based evidence that the science of scaling demands. To do so, I propose augmenting efficacy trials by including relevant tests of scale in the original discovery process, which forces the scientist to naturally start with a recognition of the big picture: what information do I need to have scaling confidence?

Comparison of Transforaminal Lumbar Interbody Fusion in the Ambulatory Surgery Center and Traditional Hospital Settings, Part 2: Assessment of Surgical Safety in Medicare Beneficiaries.

(1) Background: The clinical benefits and procedural efficiencies of performing minimally invasive fusion procedures, such as transforaminal lumbar interbody fusion (TLIF), in the ambulatory surgery center (ASC) are becoming increasingly well established. Currently, Medicare does not provide reimbursement for its beneficiaries eligible for TLIF in the ASC due to a lack of evidence regarding procedural safety. However, the initiation of the Hospital Without Walls program allowed for traditional hospital procedures to be relocated to other facilities such as ASCs, providing a unique opportunity to evaluate the utility of TLIF in the ASC in Medicare-age patients. (2) Methods: This single-center, retrospective study compared baseline characteristics, intraoperative variables, and 30-day postoperative safety outcomes between 48 Medicare-age patients undergoing TLIF in the ASC and 48 patients having the same procedure as hospital in-patients. All patients had a one-level TLIF using the VariLift®-LX expandable lumbar interbody fusion device. (3) Results: There were similar patient characteristics, procedural efficiency, and occurrence of clinical 30-day safety events between the two study groups. However, there was a marked and statistically significant difference in the median length of stay favoring TLIF patients treated in the ASC (23.9 h vs. 1.6 h, p = 0.001). All ASC-treated patients were discharged on the day of surgery. Postoperative visits to address adverse events were rare in either group. (4) Conclusions: These findings provide evidence that minimally invasive TLIF can be performed safely and efficiently in the ASC in Medicare-age patients. With same-day discharge, fusion procedures performed in the ASC offer a similar safety and more attractive cost-benefit profile for older patients than the same surgery undertaken in the traditional hospital setting. The Centers for Medicare and Medicaid Services should strongly consider extending the appropriate reimbursement codes (CPT ® 22630, 22633) for minimally invasive TLIF and PLIF to the ASC Covered Procedure List so that Medicare-age patients can realize the clinical benefits of surgeries performed in this setting.

Grade 3/4 Adverse Event Costs of Immuno-oncology Combination Therapies for Previously Untreated Advanced Renal Cell Carcinoma.

Despite 4 approved combination regimens in the first-line setting for advanced renal cell carcinoma (aRCC), adverse event (AE) costs data are lacking. A descriptive analysis on 2 AE cost comparisons was conducted using patient-level data for the nivolumab-based therapies and published data for the pembrolizumab-based therapies. First, grade 3/4 AE costs were compared between nivolumab + ipilimumab vs. nivolumab + cabozantinib vs. pembrolizumab + axitinib using data from the CheckMate 214 (median follow-up [mFU]: 13.1 months), CheckMate 9ER (mFU: 12.8 months), and KEYNOTE-426 (mFU: 12.8 months) trials, respectively. Second, grade 3/4 AE costs were compared between nivolumab + ipilimumab vs. nivolumab + cabozantinib vs. pembrolizumab + lenvatinib using data from the CheckMate 214 (mFU: 26.7 months), CheckMate 9ER (mFU: 23.5 months), and KEYNOTE-581 (mFU: 26.6 months) trials, respectively. Per-patient costs for all-cause and treatment-related grade 3/4 AEs with corresponding any-grade AE rates ≥ 20% were calculated based on the Healthcare Cost and Utilization Project database and inflated to 2020 US dollars. Per-patient all-cause grade 3/4 AE costs for nivolumab + ipilimumab vs. nivolumab + cabozantinib vs. pembrolizumab + axitinib were $2703 vs. $4508 vs. $5772, and treatment-related grade 3/4 AE costs were $741 vs. $2722 vs. $4440 over ~12.8 months of FU. For nivolumab + ipilimumab vs. nivolumab + cabozantinib vs. pembrolizumab + lenvatinib, per-patient all-cause grade 3/4 AE costs were $3120 vs. $5800 vs. $9285, while treatment-related grade 3/4 AE costs were $863 vs. $3162 vs. $5030 over ~26.6 months of FU. Patients with aRCC treated with first-line nivolumab-based therapies had lower grade 3/4 all-cause and treatment-related AE costs than pembrolizumab-based therapies, suggesting a more favorable cost-benefit profile.

Diabetes patient preferences for glucose-monitoring technologies: results from a discrete choice experiment in Poland and the Netherlands

IntroductionNew glucose-monitoring technologies have different cost–benefit profiles compared with traditional finger-prick tests, resulting in a preference-sensitive situation for patients. This study aimed to assess the relative value adults with diabetes...

Cost Analysis of Thoracic Endovascular Aortic Repair in Type B Aortic Dissection: How Much Does Quality Cost?

Aortic dissection (AD) is a life-threatening medical emergency that affects an estimated 3-4 people per 100,000 annually, with 40% of cases classified as type B AD (TBAD). TBAD can be further classified as being complicated (co-TBAD) or uncomplicated (un-TBAD) based on the presence or absence of certain features such as malperfusion and rupture. TBAD can be managed conservatively with optimal medical therapy (OMT), or invasively with open surgical repair (OSR) or thoracic endovascular aortic repair (TEVAR), depending on several factors such as type of TBAD and its clinical acuity. The cost-effectiveness, or cost-benefit profile, of these strategies must be given equal consideration. However, TBAD studies featuring cost analyses are limited within the literature. This narrative review aims to address the gap in the literature on cost-effectiveness of TBAD treatments by providing an overview of cost analyses comparing OMT with TEVAR in un-TBAD and TEVAR with OSR in co-TBAD. Another aim is to provide a market analysis of the commercially available TEVAR devices. A comprehensive literature search was performed using several search engines including PubMed, Ovid, Google Scholar, Scopus, and Embase to identify and extract relevant studies. Several TEVAR devices are available commercially on the global market costing $12,000-19,495. Nevertheless, the Terumo Aortic RELAY® stent graft seems to be the most cost-effective, yielding highly favourable clinical outcomes. Despite the higher initial cost of TEVAR, evidence in the literature strongly suggest that it is superior to OMT for un-TBAD on the long-term. In addition, TEVAR is well established in the literature as being gold-standard repair technique for co-TBAD, replacing OSR by offering a more optimal cost-benefit profile through lower costs and improved results. The introduction of TEVAR has revolutionized the field of aortovascular surgery by offering a highly efficacious and long-term cost-effective treatment for TBAD.

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Mobile stroke units save time from symptom onset to treatment in cases of acute ischaemic stroke, have a sustainable cost-benefit profile and are now recommended in European guidelines. We should investigate the use of mobile stroke units in the pre-hospital healthcare service in Norway as well.

An update of antispike severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) monoclonal antibodies.

The use of monoclonal antibodies has expanded beyond the realm of autoimmune disease and cancer therapeutics to communicable diseases. Their antiviral activities were evaluated in some diseases such as SARS MERS (Middle East Respiratory Syndrome) and Ebola. In recent times, antispike SARS-CoV-2 monoclonal antibody cocktails (casirivimab with imdevimab and bamlanivimab with etesevimab) and single agent sotrovimab have received emergency use authorization for treatment of nonhospitalized COVID-19 patients with mild-to-moderate disease at high risk of disease progression. This review summarizes their mechanism of action, salient pharmacokinetic profile, safety and clinical trial (ongoing and completed) data. Despite evidence to support its use for the indication, the high cost of these biologics may make it unaffordable for many patients, but further clinical studies on their cost-benefit profile shall provide useful information to the scientific community and patients.

Biomedical science limitations and flaws: why not choose wisely?

Biomedical science is experiencing a reassessment of its practices of healthcare management where more appropriate cost-benefit profiles are being combined with improvements in knowledge, effectiveness, and safety of diagnostic/therapeutic procedures to drive the advances in medicine. This review aims to assess: (a) possible biases of the scientific literature and research, (b) the clinical value and the cost-effectiveness of the principal medical practices and (c) the possible contribution of integrative and translational medicine. Literature shows that current medical research has cognitive (mostly industry-induced) biases that negatively impact clinical practice: the ever-increasing use of drugs and technologies, united with a certain inattention to the basic mechanisms of pathophysiology are paving the way of reductionism in medical practice. A critical view of innovations in medicine, together with a sound understanding and application of the scientific method, would improve the effectiveness, safety and sustainability of therapies. Translational and integrative medicine can contribute to develop a new patient-centered approach. Conversely, reductionism, eminence/reimbursement-based medical decisions, lack of patient education, industry-influenced science, and limited awareness from physicians may compromise the efficacy, safety, appropriateness, and cost-effectiveness of diagnostic and therapeutic processes.

Economic analysis of the costs associated with Hidradenitis suppurativa at a German University Hospital.

Background and objectivesHidradenitis suppurativa (HS) significantly affects the patient`s quality of life and leads to multiple medical consultations. Aim of this study was to assess the utilization of medical care of HS patients.Patients and methodsAll patients presenting in 2017 for an outpatient, day patient and / or inpatient treatment with leading claim type HS at the Department of Dermatology, University Hospital Würzburg, were included. Primary outcome was the economic burden of HS patients, measured by resource utilization in €.ResultsThe largest share of the direct medical costs for HS were the inpatient costs with a leading surgical diagnosis-related group (DRG). Antiseptics were the predominant topical prescription. While doxycycline was the most frequently prescribed systemic therapy, adalimumab was the main cost driver. The difference between in-patient (€ 110.25) and outpatient (€ 26.34) direct non-medical costs was statistically significant (p < 0.001). With regards to indirect medical costs, a statistically significantly higher loss of gross value added (inpatient mean € 1,827.00; outpatient mean € 203.00) and loss of production (inpatient mean € 1,026.00; outpatient mean € 228.00) could be noted (p < 0.001), respectively.ConclusionsThe present study on disease-specific costs of HS confirms that the hospital care of patients with this disease is cost-intensive. However, the primary goal of physicians is not and should not be to save costs regarding their patients`treatment, but rather the premise to utilize the existing resources as efficient as possible. Reducing the use of costly therapeutics and inpatient stays therefore requires more effective therapy options with an improved cost-benefit profile.

Cryobiopsy in Lung Cancer Diagnosis-A Literature Review.

Optimizing the diagnosis of lung cancer represents a challenge, as well as a necessity, for improving the low survival of these patients. Flexible bronchoscopy with forceps biopsy is one of the key diagnostic procedures used for lung tumors. The small sample size and crush artifacts are several factors that can often limit access to a complete diagnosis, therefore leading to the need of repeating the bronchoscopy procedure or other invasive diagnostic methods. The bronchoscopic cryobiopsy is a recent technique that proved its utility in the diagnosis of both endobronchial and peripheral lung tumors. In comparison with conventional forceps biopsy, studies report a higher diagnostic yield and a superior quality of the collected samples for both the histopathological and the molecular diagnosis of lung cancer. This method shows promising results in sampling lung tissue, alone, or in conjunction with fluoroscopy or radial endobronchial ultrasound (r-EBUS). With a good safety and cost-benefit profile, this novel method has the potential to improve the diagnosis, and therefore the management of lung cancer patients. The objective of this narrative review is to provide a comprehensive review of the recent data regarding the advantages of cryobiopsy and r-EBUS in lung cancer diagnosis.

The ethics of resource allocation in translational genomic medicine

Two basic models of the rationale of translational genomic medicine (TGM)—the “Lab Assisting Clinic” (LAC) and the “Clinic Assisting Lab” (CAL) models—are distinguished, in order to address the ethics of allocating resources for TGM. The basic challenge of justifying such allocation is for TGM to demonstrate sufficient benefits to justify the opportunity cost of lost benefits in other areas of medicine or research. While suggested ethics frameworks for translational medicine build on clearly distinguishing these models, actual TGM typically blurs them. Due to lack of and difficulty in collecting evidence, prospects for justifying the LAC model currently seem poor, but this difficulty might be overcome by more research that tests the very concept of TGM. The CAL model aims to thus advance science, but is ridden by ethical hazard, undermining attempts at justification. This leaves the notion of running bona fide controlled trials of entire TGM concepts that have been justified from the perspective of clinical and research ethics (and approved by IRBs). It remains, however, an open question if the outcomes of such trials will demonstrate benefits that can justify the investment in TGM. To advance the prospect of such justification further, charting of the cost-benefit profile of TGM compared to alternative health investments would be helpful.

Cost-effectiveness of brentuximab vedotin in advanced stage Hodgkin\u2019s lymphoma: a probabilistic analysis

BackgroundTreatment with ABVD (doxorubicin, bleomycin, vinblastine, and dacarbazine) is a well-established therapy for advanced Hodgkin’s lymphoma (HL). However, the recently completed ECHELON-1 trial showed potential net clinical benefit for brentuximab vedotin (BREN+AVD) compared to ABVD as frontline therapy in patients with advanced Hodgkin’s lymphoma. The objective of this analysis is to determine whether, on current evidence, BREN+AVD is cost-effective relative to ABVD as frontline therapy in patients with advanced HL.MethodsWe constructed a probabilistic Markov model with two arms and six mutually exclusive health states, using six-month cycle lengths, and a 15-year time horizon. Time-dependent transition probabilities were calculated from ‘real-world’ data collected by the BC Cancer’s Centre for Lymphoid Cancer database or from the literature for ABVD. Time-dependent transition probabilities for BREN+AVD were taken from the ECHELON-1 trial. We estimated the incremental cost and effects per patient of each therapy and calculated the incremental cost-effectiveness ratio (ICER). Costs were measured in 2018 Canadian dollars and effects measured in quality-adjusted life years (QALYs). A probabilistic analysis was used to generate a cost-effectiveness acceptability curve (CEAC).ResultsThe incremental cost between standard therapy with ABVD and therapy with BREN+AVD was estimated to be $192,336. The regimen of BREN+AVD resulted in a small benefit in terms of QALYs (0.46 QALYs). The estimated ICER was $418,122 per QALY gained. The probabilistic analysis suggests very few (8%) simulations fall below $100,000 per QALY. Even at a threshold of $200,000 per QALY gained, there was only a 24% chance that BREN+AVD would be considered cost-effective. Sensitivity analyses evaluating price reductions for brentuximab showed that these reductions needed to be in excess of 70% for this regimen to be cost-effective at a threshold of $100,000 per QALY.ConclusionsThere may be a clinical benefit associated with BREN+AVD, but on current evidence the benefit is not adequately substantive compared to ABVD therapy given the cost of brentuximab vedotin. Agencies responsible for making decisions about BREN+AVD as frontline therapy for patients with advanced HL should consider whether they are willing to implement this treatment given the current uncertainty and cost-benefit profile, or negotiate substantial price-reductions from the manufacturer should they choose to reimburse.

Atherothrombosis Prevention and Treatment with Anti-interleukin-1 Agents

Despite major advances in terms of prevention, diagnosis, risk-stratification, management and rehabilitation, atherosclerosis and atherothrombosis continue to have major morbidity and mortality implications worldwide. Since the unraveling of the pivotal role of inflammation in atherothrombosis pathophysiology, several focused treatments have been proposed with the ultimate goal of preventing or treating myocardial infarction, stroke, and peripheral artery disease. In particular, given the centrality of interleukin-1 (IL-1), targeted anti-IL-1 agents have attracted substantial attention and efforts. Yet, uncertainty persists on the real risk-benefit and cost-benefit balance of anti-IL-1 agents in patients with or at risk of atherothrombosis. Several trials have been recently completed on atherothrombosis prevention and treatment with anti-IL-1 agents, ranging, for instance, from the large Canakinumab Antiinflammatory Thrombosis Outcome Study (CANTOS) trial to the series of translational studies conducted within the Virginia Commonwealth University-Anakinra Remodeling Trial (VCU-ART) platform. In light of the present scoping umbrella review, it appears evident that anti-IL-1 agents can reduce systemic inflammation and improve surrogate markers of cardiac and vascular function, with potential benefits on the risk of new/worsening heart failure. One trial suggested an increased risk of major adverse events with anti-interleukin-1 agents, possibly due to a rebound phenomenon, but this was based on a post-hoc analysis of a small number of events, and it was not supported by all other pertinent trials. The CANTOS study showed a potential hazard due to an increased risk of fatal infections, but the effect size was rather small. In addition, cost issues limit the foreseeable scope of these treatment strategies in unselected patients, calling instead for more refined prescribing. The evidence base on the risk-benefit and cost-benefit profile of anti-IL-1 agents for atherothrombosis prevention and treatment has expanded substantially in the last decade. While largely dominated by the landmark CANTOS trial, effect estimates also including the VCU-ART trials suggest complex short- and long-term effects which may prove favorable in carefully selected patients with acute or chronically sustained inflammation. Conversely, more liberal use appears less promising, and further studies with currently available agents or novel ones are eagerly needed to better define their role in the era of precision molecular medicine.

A Simple Position Sensing Device for Upper Limb Rehabilitation

Stroke is a leading cause of disability which can affect shoulder and elbow movements which are necessary for reaching activities in numerous daily routines. Rehabilitation under the supervision of physiotherapists in healthcare settings is to encourage the recovery process. Unfortunately, these sessions are often labor-intensive and limited intervention time between physiotherapist and the stroke patient due to staff constraints. Dedicated robotic devices have been developed to overcome this issues. However, the high cost of these robots is a major concern as it limits their cost-benefit profiles, thus impeding large scale implementation. This paper presents a simple and portable unactuated interactive rehabilitation device for upper limb rehabilitation purposes. This device has been developed by using a conventional mouse integrated with three interactive training modules, namely the Triangle, Square, and Circle modules intended for training shoulder and elbow movements. Results from five healthy subjects showed the more deviation from the path will be happened when the subject move their hand to the other side of their dominant hand. Besides, the shape of the module that includes combination of X and Y axis direction is more difficult compare to either X or Y axis.

The underlying factors in the uptake of electricity demand response: The case of Poland

Demand response (DR) is considered crucial for a more reliable, sustainable, and efficient electricity system. Nevertheless, DR's potential still remains largely untapped in Europe. This study sheds light on the roots of this problem in the context of Poland. It suggests that unfavorable regulation is symptomatic of the real, underlying barriers. In Poland, these barriers are coal dependence and political influence on energy enterprises. As main drivers, supply security concerns, EU regulatory pressure, and a positive cost-benefit profile of DR in comparison to alternatives, are revealed. A conceptual model of DR uptake in electricity systems is proposed.

Therapeutic Drug Monitoring in Pediatric IBD: Current Application and Future Perspectives.

as the paradigm for IBD management is evolving from symptom control to the more ambitious goal of complete deep remission, the concept of personalized medicine, as a mean to deliver individualized treatment with the best effectiveness and safety profile, is becoming paramount. Therapeutic drug monitoring (TDM) is an essential part of personalized medicine and its role in the management of IBD patients is rapidly expanding. to review the current knowledge that poses the rationale for the use of TDM, and the present and future role of TDM-based approaches in the management of pediatric IBD. literature review. the concept of TDM has been introduced in the field of IBD along with thiopurines, over a decade ago, and evolved around anti-TNF therapies. TDM-based strategies proved to be costeffective in the management of patients with loss of response to biologics and, more recently, proactive TDM to optimize drug exposure has been shown to reduce treatment failure and drug adverse events. The role of TDM with new biologics and the usefulness of software-systems support tools to guide drug dosing are now under investigation. Therapeutic drug monitoring has the potential to maximize the cost-benefit profile of therapies and is becoming an essential part of IBD management.

V10-12 VIDEO DEMONSTRATION OF LAPAROSCOPIC SUTURE HYSTEROPEXY FOR UTERINE PROLAPSE USING A BI-DIRECTIONAL BARBED SUTURE

You have accessJournal of UrologyFemale Pelvic Medicine1 Apr 2018V10-12 VIDEO DEMONSTRATION OF LAPAROSCOPIC SUTURE HYSTEROPEXY FOR UTERINE PROLAPSE USING A BI-DIRECTIONAL BARBED SUTURE Sandra Elmer and Marcus Carey Sandra ElmerSandra Elmer More articles by this author and Marcus CareyMarcus Carey More articles by this author View All Author Informationhttps://doi.org/10.1016/j.juro.2018.02.2668AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookTwitterLinked InEmail INTRODUCTION AND OBJECTIVES Surgical treatment for uterine pelvic organ prolapse (POP) aims to restore the apical support of the cardinal/uterosacral ligament (USL) complex. A variety of techniques for uterosacral ligament suspension (USLS) have been described. Vaginal procedures have favourable outcomes and cost-benefit profiles. Ureteric injury occurs in approximately 5.9% of women undergoing vaginal USLS. Sacral mesh hysteropexy has a high success rate, however after the US FDA warning, there has been a growing fear of mesh complications. Our aim was to demonstrate, by video, a mesh-free laparoscopic technique that suspends the uterus from the USL, allows careful identification of the ureters, and produces excellent support of the uterus. METHODS A 39-year-old woman presented with stage II POP and had failed conservative measures (pelvic floor muscle training, pessary). She requested surgical treatment, uterine preservation and a mesh-free procedure. She was consented to laparoscopic suture hysteropexy (LSuH) with an anterior and posterior colporrhaphy and video recording of the LSuH. The technical steps of the LSuH include: 1 Uterine elevation with a uterine manipulator; 2 Identification of ureters; 3 Incision of the peritoneum above each USL; 4 Uterus suspended from each USL using a bi-directional barbed suture; 5 Careful inspection of the bowel and ureter. Paramount to this technique is appropriate tension on the bi-directional suture in order to achieve appropriate support of the uterus. RESULTS We utilised this minimally invasive technique for apical support in a patient with significant POP, and a desire to avoid mesh. Postoperatively, she was discharged home after a 2-night stay without any complications. Her postoperative convalescence was uneventful and at 6 weeks, examination revealed excellent support of all three components of the vagina. CONCLUSIONS This video demonstrates a safe and effective mesh-free technique to suspend the uterus from the uterosacral ligaments. In patients with symptomatic uterine prolapse, laparoscopic re-suspension of the uterus from the cardinal/uterosacral ligament complex is an anatomic approach for women wishing to retain their uterus and avoid mesh. Laparoscopy affords an excellent view (not achieved at vaginal surgery) of important pelvic structures such as the uterosacral ligaments, ureters, bowel, blood vessels and hypogastric nerve. Compared to vaginal surgery, the laparoscopic approach is likely to cause less ureteric injury. Further studies are required to establish the role of Laparoscopic Suture Hysteropexy. © 2018FiguresReferencesRelatedDetails Volume 199Issue 4SApril 2018Page: e1076 Advertisement Copyright & Permissions© 2018MetricsAuthor Information Sandra Elmer More articles by this author Marcus Carey More articles by this author Expand All Advertisement Advertisement PDF downloadLoading ...

Quality of bevacizumab (Avastin®) repacked in single-use glass vials for intravitreal administration.

Avastin® (bevacizumab) is an anti-vascular endothelial growth factor (VEGF) monoclonal antibody given as an off-label drug by intravitreal administration for treatment of ocular diseases. The drug's clinical application and its cost-benefit profile has generated demand for its division into single-use vials to meet the low volume and low-cost doses necessary for intraocular administration. However, the safety of compounding the drug in single-use vials is still under discussion. In this study, the stability and efficacy of Avastin® repacked in individual single-use glass vials and glass ampoules by external compounding pharmacies were evaluated. Polyacrylamide gel electrophoresis (PAGE), size-exclusion chromatography (SEC), dynamic light scattering (DLS), and turbidimetry were selected to detect the formation of aggregates of various sizes. Changes in bevacizumab biological efficacy were investigated by using an enzyme-linked immunosorbent assay (ELISA). Repacked and reference bevacizumab showed similar results when analyzed by PAGE. By SEC, a slight increase in high molecular weight aggregates and a reduction in bevacizumab monomers were observed in the products of the three compounding pharmacies relative to those in the reference bevacizumab. A comparison of repacked and reference SEC chromatograms showed that the mean monomer loss was ≤1% for all compounding pharmacies. Protein aggregates in the nanometer- and micrometer-size ranges were not detected by DLS and turbidimetry. In the efficacy assay, the biological function of repacked bevacizumab was preserved, with <3% loss of VEGF binding capacity relative to that of the reference. The results showed that bevacizumab remained stable after compounding in ampoules and single-use glass vials; no significant aggregation, fragmentation, or loss of biological activity was observed.