It is estimated that the cost of Provenge, a new treatment for advanced stage prostate cancer, will be $93,000 per patient. Company sponsored studies have shown that it increases life expectancy by about four months (from nineteen months to twenty-three months). Taxpayers will have to foot the bill since most of these patients will be Medicare and Medicare is not allowed to take into account the cost-effectiveness of drugs.
In good economic times no one would question spending that kind of money but these are not good times. There are forty million citizens who cannot afford decent medical care. The average waiting time in an Los Angeles County Emergency Room is several hours. It is highly questionable that our society can afford to provide medical care without taking into account cost-effectiveness.
As is becoming the norm, there are no independent studies on this treatment. All the studies done so far have been conducted by the company that holds the patent. Most of the study authors are company employees and stockholders. No one knows exactly how this treatment works. The studies have produced conflicting results. One study, D9902A showed no benefit for survival or disease progression. Another study, D9901 showed benefit for survival but no benefit on progression of disease. So the results of the two studies were combined and published together. This combination showed benefit for survival but no benefit on disease progression. Only time will tell if this new treatment is a real breakthrough or just a money-maker. Until that time, the taxpayers are going to spend hundreds of millions and perhaps billions of dollars, every year.