Medicare to cover $93,000 prostate cancer drug

NEWS IN BRIEF — Posted April 11, 2011

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The agency overseeing Medicare said the program will cover the $93,000 advanced prostate cancer treatment drug Provenge, according to a March 30 proposed national coverage decision memo.

Evidence suggests that autologous cellular immunotherapy treatment will improve the health outcomes of Medicare patients with asymptomatic or minimally symptomatic metastatic castrate-resistant prostate cancer, the memo states.

Provenge is not like most drugs. Doses are produced only when a physician decides to treat a patient with the drug. It is made individually for each patient using his own white blood cells.

Medicare patients currently have coverage for the drug, according to a statement from Dendreon Corp., the Seattle-based biotech company that produces Provenge. All 15 of Medicare's regional contractors have coverage guidelines or have provided written or verbal guidance on coverage. If finalized, the national coverage determination would apply the same coverage standard to all beneficiaries.

In 2009, an estimated 192,280 new cases of prostate cancer were diagnosed and 27,360 deaths were reported, according to the Centers for Medicare & Medicaid Services.

Note: This item originally appeared at

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