Pricey Provenge raises questions

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The Associated Press reported Sunday on biotech company Dendreon Corp.’s new anti-prostate cancer therapy, Provenge, which the FDA approved in April. Made with cells from a patient’s own immune system, the first so-called cancer vaccine is an all-or-nothing treatment that is individually prepared but comes with a huge price tag: $93,000. In clinical trials it only extended patients’ lives for an average of four months, although for some it increased survival by a year or more.

“Doctors and insurers increasingly are doing the cruel math that many cancer patients want to avoid, and questioning how much small improvements in survival are worth,” the AP reported.

“You can argue about whether insurance companies should pay for it or whether individuals should pay for it, but the more we allow people to use drugs that may be expensive, the more we learn,” says ACSH’s Jeff Stier. “That doesn’t mean we don’t learn from clinical trials, but there’s something to be said for the post-marketing surveillance nature of having these new drugs on the market.” And over time, adds Stier, “new expensive drugs become more affordable for everyone.”

"This situation is going to become increasingly common, as personalized drug research [pharmacogenomics] become more commonplace,” says Dr. Ross. “I fear that an enhanced focus on cost-benefit will deprive many of access to such drugs — some of whom would have been good responders despite the statistical ‘average’ patient with poor or no response.”