Medicare, First Avastin, Now Provenge

Avastin has been considered a miracle drug because of its' ability to battle certain cancers, including colon cancer, lung cancer, kidney cancer and breast cancer. But the FDA is close to rescinding approval for the drug for treatment of breast cancer. Due to the cost ($8,000 per dose) and the fact that patients given the drug live an average of 4 months longer, the FDA does not consider the drug to be "cost effective".

If the FDA decides Avastin cannot be used to treat breast cancer, Medicare will not cover the drug and neither will PDP (prescription drug plans).

Now the Washington Post reports Provenge, a drug to treat prostate cancer, may be on the chopping block.

The Centers for Medicare & Medicaid Services, which dictate what treatments the massive federal health-insurance program for the elderly will cover, is running a "national coverage analysis" of Provenge, the first vaccine approved for treating any cancer. The treatment costs $93,000 a patient and has been shown to extend patients' lives by about four months.

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.

"Not supposed to consider costs", but . . .

The review comes as the Food and Drug Administration considers withdrawing an approval for another expensive cancer treatment- Avastin for metastatic breast cancer – which triggered a similar debate even though the FDA too is not supposed to factor costs into its analyses.

I believe we see a pattern here.

"The men most impacted by prostate cancer are African American men. If CMS doesn't approve this, then this treatment becomes an exclusive kind of treatment for men who can afford it out of pocket," said Thomas Farrington, president of the Prostate Health Education Network.

Well there you go. Now this is not only a financial evaluation but a racial one as well?

You decide.

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