Medicare weighs cost, benefit of covering Dendreon's Provenge for prostate cancer

Jul 2 2010

Medicare officials are considering whether covering a drug used to treat prostate cancer is worth the cost, The Wall Street Journal reports.

The announcement that the Centers for Medicare and Medicaid Services would do this analysis "was the latest hurdle in Dendreon's push to get its Provenge treatment used. If the Centers for Medicare and Medicaid Services covers Provenge, that would increase the number of patients eligible and likely force private insurers to do the same. A denial by CMS could severely stifle the product's growth." CMS said it will complete its assessment in a year. "Provenge, seen as the first in a new class of cancer-fighting drugs, is designed to use a patient's own cells to stimulate the body's immune system to fight the cancer. However, because of its complexity, a normal three-infusion course of treatment is expected to cost $93,000, making it difficult to afford without insurance support" (Stahl, 6/30).

Reuters: "The product is the first vaccine approved to treat a type of cancer. Unlike traditional vaccines that prevent a disease, Provenge treats prostate cancer by stimulating the body's immune system to attack malignant cells. The Food and Drug Administration cleared Provenge for advanced prostate cancer after a study showed men treated with the vaccine lived an average of 4.1 months longer compared with a placebo. The vaccine is produced by taking cells from a patient's tumor and incorporating them into a vaccine that is injected back into the patient" (6/30).