Archive for Provenge
Medicare/ Trailblazer Rejects Reimbursement for Provenge & Jevtana!
Posted by: | CommentsA member of the advanced prostate cancer on-line support group who is the wife of an advanced prostate cancer survivor in New Mexico just informed us that Trailblazer (the MAC that controls New Mexico reimbursements for Medicare and Medicaid) has said they will not pay for her husband to get Provenge. They were also told by their doctor that he can’t get Medicare/Trailblazer to pay for Jevtana even though he meets the FDA approved label for failed chemotherapy.
She posted: “Jevtana for prostate cancer, Medicare doesn’t want to pay for it. We also learned today that Provenge will not be covered by Medicare & we will have to pay cash for it.
Die or use up all your retirement savings.”
She is very upset as these were his last treatment options that have demonstrated any survival advantage.
Both Provenge and Jevtana have been approved by the FDA.
This is outrageous.
Joel T Nowak, M.A., M.S.W.
An Editorial – What Has Caused the Recent Review of Provenge by the CMS
Posted by: | CommentsThere has been a lot of questions raised about why the Centers for Medicaid and Medicare Services (CMS) has out of the clear blue, launched a review of Provenge, a review that could ultimately make Provenge unavailable to men on Medicare and Medicaid (see the post:Medicare Funding for Provenge, We Urgently Need Your HELP). There has been speculation on why we are having the review, now an article in the Investors Business Daily may have shed some light on the subject.
They raise the question, has President Obama wandered into the area of health care rationing which has been previously unheard of in the United States? Read More→
The Long-Term Survival of Patients with Metastatic Prostate Cancer
Posted by: | CommentsMike Scott who writes the THE “NEW” PROSTATE CANCER INFOLINK today published an excellent summary/discussion about survival time for men with metastatic prostate cancer. He presents a synopsis about anticipated survival going back to the late 1980s and brings the conversation up to our current condition.
He reminds us that our next big step will be figuring out how to sequence the drugs we do have and how to add future drugs to best prolong survival our survival. Read More→
Medicare Funding for Provenge, We Urgently Need Your HELP
Posted by: | CommentsHow are funding decisions made for Medicare and Medicaid? What drugs are to be funded? These questions have recently come to our attention as many of us have attempted to have Medicare fund our use of Provenge.
The administration of Medicare is actually broken into 15 different regions, or MACs (Medicare Administrative Contractors). Each MAC is responsible for deciding what treatments and drugs are to be reimbursed by Medicare. Initially, decisions are made at the MAC level, so it is possible that some MACs will approve a treatment or drug while others will not.
In some instants, the Federal organization, the Center for Medicare & Medicaid Services (CMS) , will step in and create a national policy for all the MACs. In the instances of funding for Provenge, CMS has just announced that it will be reviewing Provenge and eventually make a national policy decision on reimbursement. This process can easily take up to one year! In the mean time, CMS has instructed the MACs to continue to make individual regional decisions. So, until CMS provides a national guideline, some MACs will pay for Provenge, some may not pay and others will continue to make you jump through hoops to get it covered! Read More→
Combination Therapy – A Wave of the Future – Combining Provenge & Avastin
Posted by: | CommentsWe have talked about it many times in past posts, the potential that many believe combination therapy can hold for better treatments for all cancers, including advanced prostate cancer. Combination therapy has made AIDS treatment as successful as it has become and it holds a similar promise for cancer treatment.
An example of this potential comes from a very recent phase II trial combining sipuleucel-T (Provenge) with bevacizumab (Avastin). It was found that this combination significantly increased the PSA doubling time in men with recurrent prostate cancer both after surgical and radiation therapy. Read More→
