Monday, September 27, 2010

$93,000 drug sparks debate   The treatment adds 4 months' survival, on average, for men who have incurable prostate tumors. MARILYNN MARCHIONE THE ASSOCIATED PRESS

 

Photo by: Elise Amendola Bob Svensson, 80, is hooked up to a blood infusion machine under the care of nurse Nancy Grant at the American Red Cross in Dedham, Mass., as he undergoes a $93,000 prostate cancer treatment. Svensson is honest about why he got it insurance paid. "I would not spend that money," because the benefit doesn't seem worth it.

BOSTON -- Cancer patients, brace yourselves. Many new drug treatments cost nearly $100,000 per year, sparking fresh debate about how much a few months more of life are worth.

The latest is Provenge, a first-of-a-kind therapy approved in April. It costs $93,000 per year and adds four months' survival, on average, for men with incurable prostate tumors.

Bob Svensson is honest about why he got it -- insurance paid.

"I would not spend that money," because the benefit doesn't seem worth it, says Svensson, 80, a former corporate finance officer from Bedford, Mass.

His supplemental Medicare plan is paying while the government decides whether basic Medicare will cover Provenge and for whom. The tab for taxpayers could be huge -- prostate is the most common cancer in American men. Most of those who have it will be eligible for Medicare, and Provenge will be an option for many late-stage cases. A meeting to consider Medicare coverage is set for Nov. 17.

For the past decade, new cancer-fighting drugs have been topping $5,000 per month. Only a few of these keep cancer in remission so long that they are,

need help?

Even as new cancer treatments offer hope for some, their cost is out of reach for many.

Here is a list of places from which to seek help:

* Genentech: www.Genentech AccessSolutions.com

* Novartis: http://www. patientassistancenow.com

* Patient Advocate Foundation, 800-532-5274 www.patientadvocate.org

* CancerCare, 866-552-6729 www.cancercarecopay.org

* Chronic Disease Fund, 877-968-7233 www.cdfund.org

* Healthwell Foundation, 800-675-8416 www.healthwellfoundation.org

* Leukemia & Lymphoma Society, 877-557-2672 www.LLS.org/copay

* National Organization for Rare Disorders 800-999-6673 www.rarediseases.org

* Patient Access Network Foundation, 866-316-7263 www.panfoundation.org

* Patient Advocate Foundation, 866-512-3861 www.copays.org

* Patient Services Inc., 800-366-7741 www. patientservicesinc.org

in effect, cures. For most people, the drugs may buy a few months or years. Insurers usually pay if Medicare pays. But some people have lifetime caps and more people are uninsured because of job layoffs in the recession.

 

Unlike drugs that people can try for a month or two and keep using only if they keep responding, Provenge is an all-or-nothing $93,000 gamble. It's a one-time treatment to train the immune system to fight prostate tumors, the first so-called cancer vaccine. Part of why it costs so much is that it's not a pill cranked out in a lab, but a treatment that is individually prepared, using each patient's cells and a protein found on most prostate cancer cells.

When is a drug considered cost-effective?

The most widely quoted figure is $50,000 for a year of life, "though it has been that for decades -- never really adjusted -- and not written in stone," said Dr. Harlan Krumholz, a Yale University expert on health care costs.

Many cancer drugs are way over that mark. Estimates of the cost of a year of life gained for lung cancer patients on Erbitux range from $300,000 to as much as $800,000, said Dr. Len Lichtenfeld, the American Cancer Society's deputy chief medical officer.

Higher costs seem to be more accepted for cancer treatment than for other illnesses, but there's no rule on how much is too much, he said.