There is a huge debate currently revolving around whether Provenge is worth its cost. Each infusion of Provenge will cost $31,000, bringing the full cost of the treatment for three infusions to $93,000. According to the Phase III study, the drug extends life by an average of 4.1 months, bringing the cost to about $23,000 per month of life extension.
The cost stems from the fact that every dose is unique to each patient. As I mentioned in my previous post, the treatment is composed of GM-CSF treated ex-vivo loaded dendritic cells, meaning that dendritic cells are extracted from a patient, loaded with the prostate cancer specific epitope, and treated with a GM-CSF fusion protein to help the dentritic cells to mature to improve their effectiveness at presenting antigen to T-cells. Dendreon spent close to 1 billion dollars as well as 15 years developing this immunotherapy, and is still developing three manufacturing facilities in Los Angeles, Atlanta and New Jersey for the production of this drug. Should Provenge have been approved by the FDA if it only extends a patient’s life by 4 months for a cost close to $100,000?
In my opinion, yes. During late stage prostate cancer, very few patients want to receive chemotherapy, which has many side effects and a similar prognosis in relation to the extension of life. Provenge, has very few side effects because it takes advantage of the body’s natural processes. More importantly, this approval will pave the way for other active immunotherapies and will help to jumpstart a field with incredible potential for cancer treatment. The specific debate over whether Provenge is worth the cost is difficult to answer; however, the approval of this drug was a huge step in the advancement of cancer therapeutics.
Jonathan
Sources:
Antonarakis, E.S.; Drake, C.G. “Current status of immunological therapies for prostate cancer”. Curr Opin Urol. 2010, 20, 241-246.
http://www.cnn.com/2010/HEALTH/04/27/provenge.prostate.cancer.fda/index.html
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