Suidan RS, et al. - In this observational cohort study, researchers sought to generate cost estimates of different primary management strategies in ovarian cancer. They calculated total and out-of-pocket costs using all claims within 8 months from initial treatment and normalized to 2017 US dollars, for all women (n=12,761) who underwent treatment for ovarian cancer from 2006–2015 identified from the MarketScan database. They estimated mean adjusted total costs of $113,660 and $107,153 and mean out-of-pocket costs of $2519 and $2977 for patients who underwent neoadjuvant chemotherapy and those who underwent primary debulking, respectively. For patients who had intravenous standard, intravenous dose-dense, and intraperitoneal/intravenous chemotherapy, the estimated total costs were $105,047, $115,099, and $121,761; and out-of-pocket costs were $2838, $3405, and $2888, respectively. For regimens that included bevacizumab, higher total costs were noted than those without it ($171,468 vs $104,482); out-of-pocket costs were $3127 vs $2898. Among patients who did not receive bevacizumab, 25% paid ≥$3875, and 10% paid ≥$6265. For patients who received bevacizumab, ≥$4480 were paid by 25%, and ≥$6635 were paid by 10%. Median out-of-pocket costs were $4196, with 25% paying ≥$6680 and 10% paying ≥$9751 among patients enrolled in high-deductible health plans. These observations suggest variation in costs across different treatment strategies. Further, patients, especially those enrolled in high-deductible health plans, bear a significant out-of-pocket burden.