Medicare to cover prostate cancer drug

Associated Press / March 31, 2011

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WASHINGTON — Medicare officials said yesterday that the program will pay the $93,000 cost of the prostate cancer drug Provenge, an innovative therapy that gives men suffering from the disease an extra four months to live, on average.

The Centers for Medicare and Medicaid said the biotech drug made by Dendreon Corp. is a “reasonable and necessary’’ medicine. The agency will take comments on the decision for 90 days before making it final.

Medicare is legally prohibited from considering price when deciding whether to pay for a new treatment. The Food and Drug Administration approved Provenge last April, and in most cases Medicare automatically covers drugs cleared by the agency. But Provenge’s price tag prompted debate about the cost of medical care and the government’s role in paying for it.

The agency’s decision to review Provenge last year prompted outrage from some who said Medicare was looking for a reason to avoid reimbursing for the pricey drug.

Each dose is customized to work with a patient’s immune system. Dendreon says the price reflects over $1 billion spent on research and development.