Bevacizumab Biosimilars: A Complete Guide

Mvasi, Zirabev, Alymsys, Vegzelma, Avzivi, Jobevne — and What “Biosimilar” Actually Means

Patient and Caregiver Reference | Reviewed against FDA approval records and published comparative clinical trial data

Last updated: June 2026 | Next scheduled review: June 2027 or upon new FDA approval

1. What is a bevacizumab biosimilar?

If your oncologist mentioned “Mvasi” or “Zirabev” instead of “Avastin,” you might be wondering if you’re getting a different drug. You’re not.

All of these contain the exact same active ingredient: bevacizumab. It’s an antibody that blocks a tumor’s ability to grow new blood vessels.

Brand name vs. biosimilar

Avastin is the original, brand-name version. Genentech developed and first got it approved in 2004.

A biosimilar is a separately manufactured version of that same active ingredient. A different company makes it. A regulator, like the FDA, reviews it through a dedicated approval pathway. That pathway requires proof the new product works the same way, with no clinically meaningful differences from the original.

Why this is different from a generic tablet

A generic pill can be manufactured identically to the original. It’s a simple chemical compound.

Bevacizumab isn’t simple. It’s a large, complex protein grown inside living cells. No two manufacturers can produce molecule-for-molecule identical copies, the way a chemist can replicate a small tablet.

So a biosimilar manufacturer doesn’t prove “identical.” It proves “biosimilar.” That means extensive side-by-side testing: structure, how the body processes it, and how it performs in real clinical trials against the original drug, in real patients, with real cancers.

Why biosimilars exist

Once a biosimilar clears that bar, it’s approved for the same uses as the original. The price is usually lower, since the biosimilar maker doesn’t carry the original drug’s development costs.

That’s the main reason biosimilars exist commercially. They bring competition and lower prices to an expensive class of medicine, without compromising on safety or effectiveness, when properly approved.

One terminology note worth flagging: “biosimilar” and “interchangeable” aren’t quite the same regulatory term. A biosimilar has been proven to work the same way as the original. “Interchangeable” is a separate, stricter FDA designation that can affect whether a pharmacist may substitute one for the other without checking with the prescriber first. Most bevacizumab biosimilars are approved as biosimilars; ask your pharmacist if the interchangeable designation specifically matters for your situation.

2. FDA-approved bevacizumab biosimilars

As of this page’s last update, the FDA has approved six bevacizumab biosimilars, plus the original Avastin.

Mvasi holds a special distinction. It wasn’t just the first bevacizumab biosimilar. It was the first biosimilar ever approved in the US for any cancer treatment.

Why the odd four-letter suffixes?

You’ll notice names like “bevacizumab-awwb” or “bevacizumab-bvzr.” The FDA requires every biosimilar to carry a unique suffix.

This isn’t a branding quirk. It exists so pharmacists, doctors, and safety-reporting systems can always trace exactly which manufacturer’s product a patient received. That matters if a rare side effect ever needs to be tracked back to a specific product.

Biosimilars outside the United States

Other regions have authorized additional bevacizumab biosimilars under different brand names. Canada, the European Union, and Australia have approved products like Abevmy, Aybintio, Oyavas, and Bambevi.

A growing number of biosimilars are also manufactured specifically for markets in South Asia and elsewhere. Section 7 covers one detailed example.

3. How are bevacizumab biosimilars approved?

“Biosimilar” sometimes gets misread as “close enough.” It’s worth understanding what a manufacturer actually has to prove.

The three-layer approval pathway

A biosimilar maker generally has to clear three layers of comparison against Avastin:

Analytical studies confirm the molecular structure is highly similar. Pharmacokinetic studies, in animals and humans, confirm the drug behaves the same way in the body — how it’s absorbed, distributed, and cleared. At least one large clinical trial directly compares the biosimilar to Avastin in real patients with a specific cancer, to confirm there’s no clinically meaningful difference in safety or effectiveness.

A real example: Zirabev’s approval trial

Zirabev’s approval was supported by the REFLECTIONS B7391003 trial. This trial directly compared Zirabev to Avastin in patients with advanced non-squamous non-small cell lung cancer.

The result: clinical equivalence. No clinically meaningful differences in how patients responded, or in the side effects they experienced.

This three-layer requirement is more thorough than what a small-molecule generic tablet has to clear. That’s one reason biosimilar approval has historically taken longer and required more investment than generic-drug approval.

4. Clinical efficacy and safety: how do biosimilars compare to Avastin?

The evidence-based answer: approved bevacizumab biosimilars have consistently shown comparable efficacy and safety to Avastin in their approval trials.

Differences that do show up fall within the range expected from normal patient variability. They don’t indicate one product is meaningfully better or worse.

A specific example: Alymsys

In the trial supporting Alymsys’s approval, patients with advanced non-small cell lung cancer who received Alymsys had an objective response rate of roughly 40%. Patients who received Avastin in the same study had a rate of roughly 45%.

That gap looks notable at first glance. It isn’t. It falls within the statistical margin regulators consider equivalent — the kind of variation you’d expect even running the same drug twice in two different patient groups. This is exactly what a head-to-head biosimilarity trial is designed to catch and contextualize.

Comparable detailed efficacy breakdowns are publicly available for Zirabev (see Section 3) and Alymsys. At the time of this page’s last update, we haven’t independently verified an equally detailed public comparison for Mvasi, Vegzelma, Avzivi, or Jobevne specifically — their approvals were each still based on the same three-layer pathway described in Section 3, but ask your oncologist or pharmacist if you want the specific trial data behind your own product.

Side effects track closely across all of them

Every approved biosimilar carries the same boxed-warning risks as Avastin itself: gastrointestinal perforation, wound healing complications around surgery, and serious bleeding. The same very common effects also apply — high blood pressure, fatigue, and others.

Switching between Avastin and an approved biosimilar, or between two approved biosimilars, isn’t expected to introduce new safety concerns. Any change to your treatment should still be made and monitored by your oncologist.

5. The bevacizumab biosimilars market and adoption

Biologics like bevacizumab are expensive to develop. Once a company’s market exclusivity ends, they’re also expensive for health systems and patients to keep paying for at brand-name prices.

Once Avastin’s exclusivity opened up, several manufacturers brought biosimilar competition to market.

What that competition actually achieved

According to a Q1 2025 biosimilar market dynamics report, Avastin biosimilars captured roughly 90% of the market within six years of the first launch. Average discounts ran about 49% off the brand-name product’s average sale price. For context, total bevacizumab sales were around $2 billion in 2023.

That’s a fast and substantial shift. It’s also a useful number to keep in mind if you’re wondering whether a biosimilar recommendation from your treatment center is a cost decision or a clinical one — the data suggests it’s overwhelmingly the former.

What this means for you

If your treatment center offers you a biosimilar instead of brand-name Avastin, it’s very likely a cost and formulary decision, not a clinical downgrade. It’s a reasonable, routine thing to ask your oncology team about directly.

6. Biosimilars still in development

The pipeline has stayed active well beyond the first wave of approvals. Jobevne’s April 2025 approval came nearly eight years after Mvasi’s original 2017 approval — proof that manufacturers still see value in entering an already-competitive field.

Beyond the US market

Manufacturers in Europe, Canada, Australia, and several countries building domestic biopharmaceutical capacity continue developing their own bevacizumab biosimilars.

Pipeline drugs can change status quickly, from development to submission to final approval. For the most current status on any specific unapproved product, check the FDA’s biosimilar product list or your national regulator’s registry directly, rather than relying on any single article to stay current.

7. Bevacizumab biosimilars outside the US: a closer look at Bangladesh

The pattern described above isn’t unique to the US market. Several countries have developed their own domestically manufactured bevacizumab biosimilars, both to serve local patients more affordably and, in some cases, to build export capacity.

Bangladesh is a useful example of how this plays out in a market outside the FDA’s direct jurisdiction.

Three Bangladeshi manufacturers, one active ingredient

At least three Bangladeshi pharmaceutical companies currently produce their own bevacizumab products: Eskayef Pharmaceuticals markets it as Bemab, Aristopharma markets it as Bevaris, and Incepta Pharmaceuticals markets it as Bevixa. Avastin itself is also distributed locally, through Roche Bangladesh.

What we’ve verified, and what we haven’t

All four products share the same active ingredient. That much is confirmed.

What isn’t confirmed: whether all four carry identical approved indications. We’ve verified Bemab’s own manufacturer-listed indication is metastatic colorectal cancer specifically. We have not independently verified whether Bevaris’s or Bevixa’s labeled indications are equally narrow, broader, or different. Don’t assume all four are interchangeable in scope — ask the manufacturer or your treatment center to confirm the specific approved indication for whichever product you’ve been prescribed.

A note on Eskayef’s manufacturing standing

Eskayef’s injectable manufacturing facility, where Bemab is produced, holds US FDA approval — the first facility in Bangladesh to receive that specific accreditation. It also holds UK MHRA and EU GMP certifications.

That’s a real, meaningful quality signal about the manufacturing facility itself. It’s a separate question from whether a specific published biosimilarity study comparing Bemab directly to Avastin exists — worth asking Eskayef about directly if you’re considering or using Bemab specifically.

For a complete, section-by-section walkthrough of one of these products, including dosing, side effects, monitoring, and how to verify your supply, see our full guide: Bemab (Bevacizumab): A Complete Patient Guide.

8. Frequently asked questions

Are bevacizumab biosimilars as safe as Avastin?

Yes, based on the clinical trials that supported each one’s approval. Every FDA-approved bevacizumab biosimilar had to demonstrate no clinically meaningful difference in safety or effectiveness compared to Avastin in a head-to-head trial before approval. The known risks of bevacizumab as an active ingredient, including its boxed warning for bleeding, gastrointestinal perforation, and wound healing complications, apply equally across Avastin and its approved biosimilars.

What’s the difference between a biosimilar and a generic drug?

A generic drug is a chemically identical copy of a small-molecule medicine, like a tablet. Any company can manufacture it the same way. A biosimilar is a separately manufactured version of a large, complex biologic, like an antibody, that can’t be copied molecule-for-molecule. Instead, it has to be proven highly similar through extensive comparative testing, including human clinical trials.

How many bevacizumab biosimilars are FDA-approved?

As of this page’s last update, six: Mvasi, Zirabev, Alymsys, Vegzelma, Avzivi, and Jobevne, in addition to the original brand-name Avastin. This number has grown steadily since Mvasi’s first approval in 2017 and may increase further.

Are biosimilars cheaper than Avastin?

Yes, generally. One industry report found Avastin biosimilars carry average discounts of about 49% off the brand-name product’s average sale price. Exact pricing still depends on your country, insurance or health system, and treatment center.

Can my oncologist switch me from Avastin to a biosimilar, or between two biosimilars, mid-treatment?

This is a decision for your oncologist, based on your treatment plan, your insurance or health system’s formulary, and product availability. Switching between an approved bevacizumab biosimilar and Avastin, or between two approved biosimilars, isn’t expected to introduce new safety concerns. Any change should still be made and monitored by your care team, not requested or made independently.

Medical Disclaimer

The information on this page is for educational purposes and does not constitute medical advice. Treatment decisions, including which specific bevacizumab product is appropriate, should always be made in consultation with your oncology team based on your individual clinical situation. This page was prepared using FDA public approval records and published comparative clinical trial data; consult your treatment center or the FDA’s biosimilar product list for the most current approval status.

Sources

https://www.gabionline.net/biosimilars/news/fda-approves-bevacizumab-biosimilar-jobevne
https://www.drugs.com/history/jobevne.html
https://www.bioconbiologics.com/biocon-biologics-announces-u-s-fda-approval-for-jobevne-biosimilar-bevacizumab-expanding-its-oncology-portfolio/
https://www.centerforbiosimilars.com/view/bevacizumab-biosimilars-show-similar-efficacy-safety-in-nsclc
https://www.fda.gov/drugs/resources-information-approved-drugs/fda-approves-first-biosimilar-cancer-treatment
https://en.wikipedia.org/wiki/Bevacizumab
https://www.onclive.com/view/fda-approves-third-bevacizumab-biosimilar
https://www.drugs.com/monograph/bevacizumab.html
https://www.goodrx.com/avastin/biosimilar-drug
https://biologicshq.com/fda-approves-biocons-avastin-biosimilar-jobevne-bevacizumab-nwgd/
https://www.skfbd.com/
https://www.skf-oncology.com/products/bemab
https://skfbd.com/newsandevents/eskayef-makes-history-with-us-fda-approval-for-injectable-manufacturing-facility/-cp1W0
https://medex.com.bd/generics/131/bevacizumab/brand-names
https://www.aristopharma.com/
https://www.inceptapharma.com/product-details.php?pid=624