Medicare panel backs costly cancer drug Provenge (Death Panel Stay of Execution)

Medicare advisers give vote of confidence to $93,000 drug Provenge for prostate cancer

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."

Provenge extends life in the sickest patients by a MEDIAN of four months. Half of those taking it live longer than four months and half lived less. Remember, the FDA requires testing on the nearly dead prior to allowing patients far less sick to be exposed to new therapies. A MEDIAN life extension of four months in this patient population is huge! Many of the responders lived for years more and without chemotoxic side effects!
The only approved treatment for this patient population is a Toxic Chemo (Taxotere) which only provides two months of additional life and with all the lovely side effects. Treating the side effects can cost many thousands of dollars above the cost of the Chemo (and quality of life is awful).
This secondary review of this treatment is the first indication of the coming death panels! Our grandfathers aren’t worth much to the DICKTOCRATS!

I know more about the Provenge story than I care to. Here is a safe, effective immunotherapy that was finally approved by the FDA back in April. They could have approved it back in 2007. THe chemo and government bureacracy aligned against this company and treatment is astounding. Provenge is only the first. Side effect profile is VERY mild, a few fevers, chills. THe treatment cost is high but a company has to recoup their years of research investment, nearly 1 billion dollars. They took the risk, they conducted the trials, they proved the first immunotherapy for cancer WORKS!!!!!!! THe treatment cost is a one time cost, not cost per year. THe ony other approved treatment, Taxotere, has side effects so bad that ma y men refuse to take it. Add the cost of that treatment, the medications and additional doctor visits and hospitalizations needed just to stay on it and the cost or Provenge is comparable. This treatment is threatening government funded research fat cats and well entrenched chemotherapy interests from the FDA to big pharmaceutical companies on down. It is a sordid story. The Centers for Medicare initiated their review after the FDA already approved the drug. Their decision today and their sham hearing did not disclose anything new. A huge waste of taxpayer dollars and self-important bureaucrats. They lost today, the patients won.

Thank you Mr (or Mrs. LX).

Cause that was my FIRST thought.

We do, us boobs out here in la-la land, have a whole bunch of common sense that the Ruling Class does not have.

We are all, with our pets on up to our parents, faced with imminent death and we all make decisions based on quality of life versus length of life versus....on some level...cost.

An extension of death by cancer by four months, I’m not convinced this is such a good thing.

I can see this problem clear down the road. We’ve got a 85 year old man dying of prostate cancer. This drug might extend his life by four months. The Lamestream, and Paul Krugman of course, would be all snippy and justified, declaring the expense of giving this old geezer four more months will bankrupt the country.

When the fact is, I’d argue with no statistical proof save a very strong hunch, an 85 year old geezer would probably refuse those extra four months as....come on.

That’s the problem, a whole lot of factors enter into the equation of when to go to extraordinary measures to extend life. There’s age, general health, disposition, family feelings, cost....to some extent, face it, we deal with it.

For decades now we’ve been out here in la-la land dealing with this and we get along just fine.

But to have a government bureaucrat deciding it? That’s the rub.

$97,000 to extend a cancer-riddled life by four months sounds more like some pharmaceutical company trying to make a quick bonznza instead of any kind of miracle drug breakthrough.

You have to dig a bit further than the headline. More than 33% of the patients treated with Provenge were alive more than 3 YEARS!!!..Taxotere, if you chose to take it, would extend your life, too. I think it’s median is 21 months. Provenge adds 4 months to that without the side effects. That’s the 4 month median, it’s added on to the benefit of existing therapy.

Be careful with how the story is prointed, it is a distortion. Median is not the MEAN, it is a midpoint. 50% of the patients live far longer and gain a quality of life without the toxicities of chemotherapy.

Thank you SueRae.
I know nothing about this particular drug, but your explanation tends to clarify the problem with the “statistics” for me.

I am even more interested in the fact you used the term “effective immunotherapy” regarding this treatment.

There are burbles and bubbles in the internet community suggesting cancer,in many if not all varieties, would be far easier and cheaper to treat and/or cure, if there was way less “government subsidized financial incentive” for the current, less effective medical “treatments” to continue.

I'm not normally one who listens to conspiracy theories, but my ears are perking up on this topic.
Sorry to be late to researching the topic.
If you have a ping list, please add me.

I would like to give you a more detailed reply right now but I am on business travel and my time is limited. I PROMISE I will get you more information. In the meantime, what Dendreon has done has not been successful before now. They have harnessed the body’s own immune system to fight the most common and dealy cancer in men. Each treatment is custome made for the patient,not a one size fits all approach. The treatment is not a drug. A patients’s blood is drawn in a doctor’s office and the cells isolated in a process called apheresis. The blodd is shipped to the Dednreon plant where it is infused with an antigen developed to stimulate the body’s defenses against a particular prostate-cancer antigen. Once the blood is ‘supercharged’, the blood is then transfused back into the patient. This is done a totalof 3 times over 4-6 weeks and that is it!. Side effects are generally mild, rangin from chills, fevers, in other words,a typical immune response. The reinfused blood contains the immune cells which continue to enhance the body’s ability to fight the cancer. It takes some time for the body to rebuild it’s immune system but some of the patients in the clinical trial are still alive and I know of one that lived more than 9 years. Keep in mind that these men were terminally ill. Today’s hearing was about costs. The treatment has been approved for the sickest of patients, however, the treatment could provide a “cure” for many if given earlier in the disease pregression. That is called “off-label” use and that is where the real money would be made by a company with an approved drug. The CMS hearing (in my opinion) was to strictly limit coverage to only those patients for Dendreon’s FDA approved (or on-lael) inddication. Further clinical trials to prove a survival benefit for those with earlier stage prostate cancer will take years and $$$$$$$. But I believe it will eventually happen. And Dendreon has other cancer targets waiting to come into clinical trials. We believe that bladder cancer will be the next therapy into the clinic. Bottom line - the treatment is an individualized, non-toxic therapy that harnesses the patients’ own immune system (instead of suppressing it) to fight the cancer within. I have huge hopes for this approach but it scares the heck out of a huge portion of the chemo community. Chemotherapy will still be needed ...at least for awhile, but training a person’s own system to fight their cancer has been the Holy grail of cancer therapy. Give it time...and watch for further news...and hope. Cancer will one day become as manageable as diabetes, I’m convinced of it. And I’m convinced that Dendreon’s Provenge will prove it.

Sorry for the long-winded answer. My mother died a horrible death from rectal/colon cancer, mostly due to the side effects of treatment...and I studied many treatments and therapies looking for something that would give a patient dignity and a quality of life. I feel very strongly about quality of life. Provenge does just that for prostate cancer sufferers.

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