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Will Provenge be covered by Medicare & Medicaide in the USA?
Dendreon Corp. (NASDAQ:DNDN)
Center for Medicare & Medicaid Services) issued a report regarding coverage on cancer drug Provenge. The report on the CMS website said:
“We are opening this national coverage analysis to determine whether or not autologous cellular immunotherapy is reasonable and necessary under sections 1862(a)(1)(A) and/or 1862(a)(1)(E) of the Social Security Act.”
Dendreon issued the following statement early this evening:
Dendreon Corporation announced that the Centers for Medicare and Medicaid Services (CMS) today initiated a National Coverage Analysis (NCA) of PROVENGE® (sipuleucel-T), an autologous cellular immunotherapy for the treatment of asymptomatic or minimally symptomatic metastatic, castrate-resistant (hormone-refractory) prostate cancer (CRPC). PROVENGE is the first in a new therapeutic class known as autologous cellular immunotherapies.
In CMS’s announcement of the NCA, CMS is requesting public comments on the effects of PROVENGE on health outcomes in patients with prostate cancer. It is not a change in Medicare coverage policy.
NCAs do not impact existing coverage decisions, nor do they restrict local Medicare contractors from covering PROVENGE. Therefore, Medicare beneficiaries are still able to access PROVENGE and private payers can also still cover PROVENGE.
Dendreon welcomes the opportunity to continue our discussions with CMS about how PROVENGE will be provided to Medicare beneficiaries, particularly given the survival benefit and safety profile of PROVENGE. We plan on continuing to work closely with CMS during this process to ensure patients with advanced prostate cancer have broad access to PROVENGE.
With the cost and availability of this drug, I think it will be a tough battle, but lets hope for the Patients sake, that they agree to cover it.
