Thread: Medicare panel backs $93K cancer drug Provenge

Medicare panel backs $93K cancer drug Provenge

WASHINGTON (AP) — Medicare advisers on Wednesday supported the effectiveness of the prostate cancer drug Provenge, an innovative therapy that has prompted questions about the cost of medical care and the government's role in paying for it.

The vote by a 14-member panel of outside experts amounts to a recommendation that Medicare pay for Provenge, which costs $93,000 per patient and extends life an average of four months.

The Centers for Medicare and Medicaid Services will make a final decision on the drug in March, and a positive ruling would make the drug available to tens of thousands of seniors diagnosed with prostate cancer. Most analysts expect Medicare to pay for the drug, giving drugmaker Dendreon Corp. a blockbuster product worth up to $2 billion in sales per year.

The agency already pays for other innovative cancer drugs from companies such as Genentech and Eli Lilly that have similar price tags and survival benefits.

Medicare is legally prohibited from considering price when deciding whether to pay for a new treatment, and the agency's decision to review Provenge prompted outrage from some patient groups who said the drug should be paid for immediately.

But experts say that as health care costs climb, both public and private insurance providers are being forced to demand better evidence for new drugs' benefits.

"CMS will never admit that cost is a part of the reason they opened up the national coverage decision, but I think it definitely is," said David Blaszczak, a Potomac Research Group analyst who previously worked for the agency. "If this product was only $200 we wouldn't be going through this process."

The Food and Drug Administration approved Provenge in April as the first cancer drug that uses the body's own immune system to fight the disease, offering an alternative to chemotherapy drugs that attack cancerous and healthy cells at the same time.

Most observers expected Medicare to pay for it immediately, as it does with most drugs. But Medicare officials said in June they would conduct their own review, triggering protests from patient groups.

"We believe that if the FDA approves a treatment option, that Medicare and insurance companies should provide unrestricted access," said Tom Kirk, president of US Too International, a prostate cancer advocacy group, in a petition to Medicare officials.

Medicare officials say cost has nothing to do with its review, and point out they have conducted similar reviews of four other cancer drugs in recent years.

Instead, the agency's review is aimed at clearing up bureaucratic confusion among Medicare carriers across the country, some of whom already pay for Provenge, while others do not, CMS spokesman Don McLeod said.

"When this happens, we frequently look at creating a national policy to clear up the conflict," McLeod said. "What we're doing is not unusual."

Dan Mendelson, president of Avalere Health consultants, says Medicare's review of Provenge is primarily a signal to drugmakers that the agency will not automatically pay for drugs just because they have been cleared by the FDA. Medicare officials want to see more data on how drugs work in the more than 47 million seniors covered by the program.

"It is an important and valid thing for the government to seek further evidence about how a medicine works in the Medicare population, but this is coming out at a very politically charged time," said Mendelson, who worked on health care issues in the Clinton administration.

Earlier this month, Republicans swept Democrats out of power in the House of Representatives and state capitals, in part by campaigning against President Obama's health care overhaul passed in March. The plan is designed to cover 30 million additional Americans while reducing health care costs in the long run. But Republicans have vowed to repeal the law, which they've called a "government takeover" that will ration care for patients.

http://www.usatoday.com/yourlife/health ... care_N.htm

Medicare pay for Provenge, which costs $93,000 per patient and extends life an average of four months.

What a waste of money.

If this drug extends life 4 months,why are they holding back. It just sounds crazy.

Someone will make a hell of a lot of money for something THEY SAY will extend lives. WHY?

There are ones that want to end their lives due to pain and misery and they won't let them do that.

How do you really know a drug will extend your life? 4 months!

Originally Posted by uniteasone

. . . How do you really know a drug will extend your life? 4 months!

Like all drugs it has to be tested before it is put on the market, so they have the research to prove it.

Sipuleucel-T
From Wikipedia

Sipuleucel-T, marketed by Dendreon under the brand name Provenge, is a patient specific cancer vaccine for prostate cancer. However, unlike traditional prophylactic vaccines designed to prevent diseases, Sipuleucel-T is a therapeutic vaccine designed to treat the disease itself.

Sipuleucel-T is the first therapeutic cancer vaccine to demonstrate effectiveness in Phase III trials by prolonging life of patients who have advanced to the late stage of the disease, hormone-refractory prostate cancer (HRPC). THe other names for this stage are Castrate-Resistant (CRPC) and Androgen Independent (AIPC). [1] [2] [3] Its approach to elicit an immune response against cancer cells results in a novel and uniquely effective treatment that "could extend the life of prostate cancer patients with far fewer of the harsh side effects of traditional treatments such as surgery, radiation and chemotherapy." [4] [5] [6]

Sipuleucel-T was approved by the U.S. Food and Drug Administration (FDA) on April 29, 2010 to treat asymptomatic or minimally symptomatic metastatic HRPC. [7] [8] Shortly afterward, Sipuleucel-T was added to the Compendium of cancer treatments published by the National Comprehensive Cancer Network (NCCN) as a "category 1" (highest recommendation) treatment for HRPC. The NCCN Compendium is a source sanctioned by Medicare and used by major healthcare insurance providers to decide whether and when a treatment should be given to a patient requesting it. [9] [10]

http://en.wikipedia.org/wiki/Sipuleucel-T

BUT how do you KNOW your life is EXTENDED 4 months?

Originally Posted by uniteasone

BUT how do you KNOW your life is EXTENDED 4 months?

I don't. That's why I said that it was a waste of money. (See my first comment.)

I wouldn't spend $93,000 of my own money to maybe keep me alive for 4 months

and I don't think Medicare should either, for me or anyone else.

Friend of mine had cancer, doctors couldn't cure it.

He cured it himself by eating only organic food, drinking distilled water, eliminating sugar, and drinking sauerkraut juice. He has been cancer free for years and is riding his bike across the US next year at age 70.

Originally Posted by Bowman

Friend of mine had cancer, doctors couldn't cure it.

He cured it himself by eating only organic food, drinking distilled water, eliminating sugar, and drinking sauerkraut juice. He has been cancer free for years and is riding his bike across the US next year at age 70.

Agreed and that goes for heart health as well