Dendreon's $93,000 prostate cancer drug: Is Provenge worth it?

(CBS/AP) Are four months of life worth $93,000? Medicare officials seem to think so. They said Wednesday that the program will pay that much for Provenge, a first-of-a-kind therapy that can give men with incurable prostate cancer an extra four months to live.

Prostate cancer patients point out that the median survival time with Provenge is twice that of chemotherapy, which is marked by significant side effects.

The Centers for Medicare and Medicaid called the drug made by Dendreon Corp. a "reasonable and necessary" medicine. The decision ensures that millions of men would be able to afford the drug through Medicare. Most prostate cancer patients are 65 or older.

Medicare is prohibited from considering price when deciding whether to pay for a new treatment. The FDA approved Provenge last April and in most cases Medicare automatically covers drugs cleared by the agency. But Medicare's decision to review Provenge last year prompted outrage from patients and doctors who said the government was looking for a reason to avoid paying for the pricey drug.

Provenge is the first FDA-approved cancer drug that uses the body's own immune system to fight the disease, offering an alternative to chemotherapy drugs that attack cancerous and healthy cells at the same time. The treatment is intended for men whose prostate cancer has spread elsewhere in the body and is not responding to hormone therapy or radiation.

Each regimen of Provenge must be tailored to the immune system of the patient using a time-consuming formulation process. Doctors collect special blood cells from each patient that help the immune system recognize cancer as a threat. The cells are mixed with a protein found on most prostate cancer cells and another substance to rev up the immune system, and then given back to the patient as three infusions two weeks apart.

Bioethicists who study health care decisions say Medicare's ruling on Provenge mirrors the bias of the overall U.S. health system, which emphasizes costly treatments over basic medical care. Health care costs account for nearly one fifth of the U.S. economy, more than any other country.

"We tend to put our health care dollars into very high-tech interventions that produce very marginal improvements," said Dr. Steven Miles, a professor at the University of Minnesota's Center for Bioethics. "The problem is that we have created a health care system that is uniquely inadequate in terms of access to primary health care, which is where you get the most bang for your buck."