Centers for Medicare and Medicaid Services Considering Full Coverage of Provenge Treatment Expense

On March 30, 2011 the U.S. CMS (Centers for Medicare and Medicaid Services) insurance program announced a proposal of full coverage payment of Provenge (Sipuleucel-T) therapy for the advanced metastatic stage prostate cancer patients. Along with its proposal, the insurance said there is an adequate evidence to pay for the expenses but for now the agency is still weighing the benefits of the therapy treatment and the final decision is expected by June 30 of next year. An advisory panel in the United States also backed Provenge by suggesting that the available data showed by the Dendreon Corporation could help patients. It is certainly a cause for concern when people see the cost of expenses of the treatment; many are considering the cost and benefits as well as its guarantees with regards to prolonging survival rates. This article wishes to provide readers information about Provenge therapy and the role of the CMS agencies.

Provenge (Sipuleucel-T) is a type of immunotherapy that is designed to treat and improve the lives of patients with an advance and recurrent prostate cancer who have become resistant to hormone therapy and who are non-respondent to other treatment modalities. This therapy works by obtaining the white blood cells of a patient and is incubated to a specific prostate antigen to specifically target the tumor when it is returned back to the body. This therapy induces an immune response against the prostate tumor. Provenge therapy costs $93,000 for three infusions given at a one month course of duration.

Provenge was approved by the Food and Drug Administration last April 2010. Data studies showed that Provenge increases survival by 4.1 months on average. According to Dr. Mark Scholz, a California based prostate oncologist and one of the public speakers urging for the CMS support for Provenge, "Provenge is a new agent that is clearly beneficial for patients". Patients, doctors and Dendreon Company urge the Medicare's advisers to pay for the high cost of therapy. Medicare payment coverage could also encourage other private insurances to pay for the expense. Aetna Inc and Humana Inc and some other health agencies have already agreed to pay for the therapy. According to the consensus analyst forecast data from Thomson Reuters, Provenge could see more than $2 billion in global sales by 2015.

The question left for us now is that who is really gaining the benefit, is it the company, the hospital, the doctors or the patients? Provenge therapy is needed by patients who have become resistant to other treatment modalities, this are the patients who have tried everything and spent everything just to lengthen their life frame. Living in this world, the cost of money does not amount to every second of our lives. Provenge is a chance given to the patients' nearly approaching death and the high cost of treatment can never amount to the happiness of spending our time with our families, friends and loved ones.