Your Patients Need Bevacizumab — Here's How to Help Them Get It

As an oncologist or prescribing provider, you already know that Bevacizumab supply disruptions can derail carefully planned treatment regimens. When your infusion center pharmacy tells you a particular Bevacizumab product is on backorder, you need actionable solutions — not just awareness of the problem.

This guide provides a practical, step-by-step approach to help your patients access Bevacizumab when supply is tight.

Current Availability Landscape

Bevacizumab is now available from seven manufacturers:

• Avastin (bevacizumab, Genentech/Roche) — reference biologic
• Mvasi (bevacizumab-awwb, Amgen) — biosimilar, approved 2017
• Zirabev (bevacizumab-bvzr, Pfizer) — biosimilar, approved 2019
• Alymsys (bevacizumab-maly, Amneal) — biosimilar, approved 2022
• Vegzelma (bevacizumab-adcd, Celltrion) — biosimilar, approved 2022
• Avzivi (bevacizumab-tnjn, Samsung Bioepis) — biosimilar
• Jobevne (bevacizumab-nwgd, Sandoz) — biosimilar, most recently approved

Despite this expanded market, shortages of individual products persist due to manufacturing complexity, GPO contracting dynamics, and the ongoing maturation of biosimilar supply chains. For the broader shortage context, see our provider shortage briefing.

Why Patients Can't Find Bevacizumab

Understanding the bottlenecks helps you troubleshoot more effectively:

Single-Source Contracting

Many practices and hospital systems contract with a single Bevacizumab manufacturer through their GPO. When that manufacturer experiences a shortage, the entire practice loses access — even though other products are available in the broader market.

Formulary Rigidity

Institutional formularies may list only one or two Bevacizumab products, creating barriers to rapid substitution. P&T committees may need to add additional biosimilars to the formulary, a process that can take weeks even on an emergency basis.

Patient Location and Access

Patients in rural areas or those tied to specific health systems may have fewer options for alternative infusion sites. Transportation, appointment availability, and insurance network restrictions add complexity.

Reimbursement Uncertainty

Some practices hesitate to stock biosimilars they haven't used before due to uncertainty about payer reimbursement rates, especially in the buy-and-bill model where acquisition cost vs. ASP-based reimbursement margins matter significantly.

What Providers Can Do: 5 Actionable Steps

Step 1: Maintain Multi-Source Contracts

Work with your purchasing department or GPO to maintain active contracts with at least two Bevacizumab manufacturers. This is the single most effective protection against individual product shortages. Ensure your pharmacy can order from an alternate supplier within 24-48 hours.

If your current GPO contract is exclusive, negotiate carve-outs for shortage situations that allow purchasing from secondary sources at competitive rates.

Step 2: Update Your Formulary Proactively

Ensure your institutional formulary includes multiple Bevacizumab products. Submit a P&T committee request to add at least 2-3 biosimilars as formulary alternatives. Build order sets in your EHR that can accommodate any Bevacizumab product, using standardized dosing protocols that reference the generic name rather than a specific brand.

Step 3: Use Real-Time Availability Tools

Medfinder for Providers lets you check Bevacizumab stock at facilities in your area in real time. When your primary supply is disrupted, this tool can help you quickly identify alternative sources — whether that's another facility that can administer the infusion or a distributor with available inventory.

Bookmark these monitoring resources:

• Medfinder for Providers — real-time facility-level availability
• ASHP Drug Shortage Database — updated shortage status and estimated resupply
• FDA Drug Shortage Database — manufacturer-reported supply information

Step 4: Establish Referral Pathways

Identify 2-3 alternative infusion sites in your area — hospital outpatient infusion centers, independent infusion centers, or neighboring oncology practices — that you can refer patients to when your facility can't source Bevacizumab. Establish relationships in advance so that referrals can happen quickly during a crisis.

Create a standard process for transferring infusion orders, including treatment plans, dosing history, and monitoring requirements, so patients experience minimal disruption.

Step 5: Communicate Proactively With Patients

Don't wait until infusion day to inform patients about supply issues. As soon as you become aware of a potential disruption:

• Contact affected patients with a timeline and plan
• Explain biosimilar substitution in clear, reassuring terms
• Provide specific alternatives (different product, different site, or short delay with clinical rationale)
• Share patient-facing resources: Bevacizumab shortage update for patients and how to find Bevacizumab in stock

Therapeutic Alternatives to Consider

When Bevacizumab is unavailable in any formulation, indication-specific alternatives include:

• mCRC: Ramucirumab (Cyramza) with FOLFIRI; Ziv-Aflibercept (Zaltrap) with FOLFIRI; Regorafenib (Stivarga) for later-line
• NSCLC: Ramucirumab (Cyramza) with docetaxel (second-line); consider regimens without anti-VEGF component
• HCC: Ramucirumab (for AFP ≥400 ng/mL); Lenvatinib (Lenvima) with Pembrolizumab; Sorafenib
• RCC: Lenvatinib with Pembrolizumab; Cabozantinib; Axitinib with Pembrolizumab
• Glioblastoma: Limited alternatives; consider Lomustine or re-irradiation per NCCN guidelines
• Ovarian/Cervical: Consult NCCN guidelines for regimen modifications without anti-VEGF; consider Olaparib (for BRCA+ ovarian)

Refer to current NCCN guidelines for indication-specific recommendations and evidence levels. For a patient-facing summary, direct patients to our alternatives to Bevacizumab guide.

Workflow Tips for Shortage Management

• Assign a shortage liaison: Designate one staff member (pharmacist, nurse, or coordinator) to monitor Bevacizumab supply daily and escalate issues immediately
• Create a shortage playbook: Document your practice's step-by-step response plan for Bevacizumab shortages, including contacts for alternative suppliers, referral sites, and patient communication templates
• Track inventory proactively: Monitor your Bevacizumab inventory at least weekly. When supply drops below a 2-week buffer, activate your shortage protocol
• Document everything: Record shortage-related treatment modifications in the patient chart, including clinical rationale for delays, biosimilar switches, or alternative therapies. This supports continuity of care and payer documentation requirements
• Leverage financial assistance: When patients face cost barriers compounding access issues, connect them with Genentech Avastin Access Solutions at (855) MY-COPAY, or refer to our provider guide to helping patients save money on Bevacizumab

Final Thoughts

Bevacizumab shortages are a manageable challenge when you have the right systems in place. Multi-source contracting, updated formularies, real-time availability tools like Medfinder for Providers, established referral pathways, and proactive patient communication form a resilient framework that can weather supply disruptions.

Your patients depend on you not just for clinical expertise, but for navigating the increasingly complex medication access landscape. With the right preparation, you can ensure that Bevacizumab supply issues don't become treatment gaps.