There is a brief article on Provenge and its use for prostate cancer in
NEJM. Now Provenge is a new and supposedly targeted drug for metastatic androgen resistance prostate cancer. As NEJM states:
...sipuleucel-T (Provenge), a novel cellular immunotherapy for the treatment of asymptomatic or minimally symptomatic, metastatic, castration-resistant (hormone-refractory) prostate cancer The pivotal clinical trial demonstrated the benefits of sipuleucel-T: an increase in median survival of 4.1 months as compared with placebo and fewer side effects than occur with docetaxel. Priced at $31,000 per treatment, with a usual course of three treatments, sipuleucel-T is one of the most expensive cancer therapies ever to hit the marketplace.
Yes that is $30,000 per treatment! The question is then should one have Medicare pay for this for all AR PCa patients. It does not really cure and has a limited ability to improve quality of life and survival as best as one can ascertain. This is a question which goes to the heart of the health care debate.
This is a difficult question, since there are many tens of thousands of men in that state at any one time. At roughly $100,000 per patient per year, the number is in the billions, and the benefit is questionable. Men should be able to choose, but at what price, what should Medicare cover? Worth a discussion.
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