The debate over health care reform extends well beyond politicians and lobbyists.
Academics and health care professionals are scrambling to weigh in on possible fixes to a system whose costs are either chewing up or beefing up the bottom lines of American business — depending on whether the company is paying for health insurance or selling health care products.
The Website of the prestigious New England Journal of Medicine recently explored the cost-benefit analysis of innovative, yet expensive and limited use treatments in a report titled “Listening to Provenge – What a Costly Cancer Treatment Says About Future Medicare Policy.”
The report, authored by two researchers at the Center for the Evaluation of Value and Risk in Health at Boston’s Tufts Medical Center, focuses on a new treatment for prostate cancer, wherein the drug, Provenge, primes the patient’s own immune system cells to attack cancer cells.
The cutting-edge technology has no significant side effects, but also happens to have almost no measurable effects of any kind: Tumors don’t shrink. Blood tests are unchanged. But men with otherwise intractable prostate cancer who get the procedure tend to live a bit longer —4.1 months is the median.
And it’s very, very expensive — about $93,000 for a course of treatment.
The Food and Drug Administration approved Provenge, developed by Dendreon , in April 2010. Likewise Medicare. Those approvals were for men with the most severe form of prostate cancer. But would Medicare pay for so-called off-label use, where doctors prescribe a drug or procedure for a use not formally approved by the FDA?