UPDATE 11-17-10: An advisory panel recommended today that the drug be covered by Medicare. A final decision will be made this spring.
Last spring, I wrote about the FDA's approval of Provenge, a vaccine treatment for prostate cancer. (The drug, which was developed at Stanford, was the first-ever cancer vaccine to get the FDA's nod.) Now, the federal government has launched what is being called an "unusual" review to determine whether the treatment, which costs $93,000 and can extend a patient's life by about four months, should be covered under Medicare. Rob Stein with the Washington Post reports:
Although Medicare is not supposed to take cost into consideration when making such rulings, the decision to launch a formal examination has raised concerns among cancer experts, drug companies, lawmakers, prostate cancer patients and advocacy groups.
Provenge... is the latest in a series of new high-priced cancer treatments that appear to eke out only a few more months of life, prompting alarm about their cost.
"This absolutely is the opening salvo in the drive to save money in the health-care system," said Skip Lockwood, who heads Zero - the Project to End Prostate Cancer, a Washington-based lobbying group. "If the cost wasn't a consideration, this wouldn't even be under discussion."
Stein notes that Medicare officials "say Provenge's price tag isn't an issue." But the review has still rekindled debate over whether some therapies are just too costly for Medicare coverage. And experts predict this isn't the last we'll hear of discussion about the costs and benefits of medical treatments:
"At some point, if we keep paying these very high prices for treatments that provide very limited benefit, we're going to reach the point where we can no longer afford health care," said Alan Garber, a professor of medicine and economist at Stanford University. "Some say we're living through that right now."