Provenge

Thanks Todd!!!! Great read!!!

Great post!

Keep writing.
Andrew

Todd,
Thanks for that great post and info, nice drawings too, those c-cells look like aliens,like the ones near where I work, not far from Area 51!
Dan 100 degrees today at Edwards Air Force Base.

Post Edited (Wings of Eagles) : 7/15/2016 10:13:27 PM (GMT-6)

Provenge was, unarguably, an incredibly innovative concept in its time.

But it's earned the label as the least cost effective clinical cancer intervention ($272,000 LYS) ever, sparking wide debate amongst medical ethicists.

I hope the can leverage the learnings quickly and develop something new/better.

Furthermore I would like to point out that although I think Zytiga is a fine medication that the cost of Zytiga for the same 17 month time frame was 102k plus monthly lab work to make sure it is not killing the liver. Provenge is basically a 1 and done

JackH said...
Provenge was, unarguably, an incredibly innovative concept in its time.

But it's earned the label as the least cost effective clinical cancer intervention ($272,000 LYS) ever, sparking wide debate amongst medical ethicists.

I hope the can leverage the learnings quickly and develop something new/better.

Todd, what part of this do you thing is mis-information?

The "label" has absolutely nothing to do with the duration of the treatment period of men on provenge...

And the medical ethicists care nothing about how much YOU paid or didn't pay...

Todd glad you are doing well. /We Provenge Alums need to stay around for many years to prove it really has made a difference in our lives. Keep up the great work.

JNF
Thanks for that info..you are Just Now my Favorite!
Dan

Post Edited (Wings of Eagles) : 7/17/2016 9:49:32 AM (GMT-6)

Todd, we (myself included) DO appreciate the considerable amount of work you have done in actively protesting the high cost of Provenge--traveling all over the country in protest--and using your inside leverage to make the cause for reducing pricing/better healthcare in this country; in doing so, you can potentially help many others in the future. Thank you for your service.


I didn't realize it at the time, but there WAS some MISINFORMATION in my original post. Let's deconstruct it, fix the problem, and put it back together for the benefit of others who will potentially read this in the future. The original post was just 3 sentences, so this should be easy:

(1) Provenge was, unarguably, an incredibly innovative concept in its time. Well, that was my opinion. There's no misinformation in that because the opinion is mine, and I'm sticking with it.

(2) But it's earned the label as the least cost effective clinical cancer intervention ($272,000 LYS) ever, sparking wide debate amongst medical ethicists. I guess by "misinformation," you simply meant "aged-information." The calculations for the least cost effective cancer intervention were based on the original Provenge cost of $93K...but folks have provided helpful insight that their insurance companies are billed much higher today. Now we're at $131K. I'll leave the easy re-calculation of latest LYS to the students. The important point--the point which makes this data, and the point, entirely relevant today in 2016--is that numerator has gone up but the denominator has NOT changed.

(3) I hope the can leverage the learnings quickly and develop something new/better. Again, I'm going to claim that is my opinion--which is why it started with "I hope," so any claim of misinformation is out-of-bounds on this sentence, too. I'm going to stick with what I said. It was a very novel idea.


Ya gotta chuckle about the naive comments on how little the drug is costing you. "Problem? There's no problem." Believe it or not, it's not all about you. When you don't pay, everyone else pays a little bit more. That's the big reason Medicare is going broke. Did you know that the budget for Medicare Part B--that's the plan the covers all drugs that are not self-administered--is 75% consumed by just 9 drugs, Provenge being one of the nine despite the relatively small number of men treated?

I just hope we can do better...soon.

Post Edited (JackH) : 7/17/2016 2:22:58 PM (GMT-6)

Wings, thanks for the update.

I couldn't agree more with your earlier comment: "Please realize we are all free to express an opinion." I can definitely live by that...but hope that it goes 2-ways, too. After all, 2/3 of my original post in this thread was my opinion, and only 1/3 data...although that ratio was unusually low for my typical postings. I usually enlist the data, and opinions, of folks much smarter than I am, and share that information in my posts. I don't think I did anything here to curtail anyone's freedom to express an opinion...hopefully.

Todd1963 said...
This is just to let everyone know I wrote a blog post about Provenge. See link in signature

Todd, thanks for the layman's explanation of how Provenge works.

In 2014, when I had the 3 Provenge cycles as part of my combination therapy with SBRT and Lupron/Zytiga, I was more concerned that it worked than with how it worked, but glad to now know more about why it worked.

You took the tour of the Dendreon Seal Beach CA facility, closest I came was my white blood cells and plasma made the trip on 3 every other Fridays in 2014, but apparently only 25% of them came back into my bloodstream the following Monday to continue the fight against PCa.

I make the analogy to chicken pox vaccine or flu shot, except it is our own blood rather than the chicken's and there are 3 cycles rather than one.

Like Sonny said once you get the two consecutive PSA increases, time to investigate early chemo or Provenge first, and then if necessary move on to Xtandi, Zytiga etc plus any new remedies that come into the pipeline.

Well said brother Todd. The question is not cost....it is value. Very apparent for you and Mandy the value of your treatment and its continued success.

If it is all about cost, then let's just deny any drug or treatment that costs over.....pick a number. Is that the American way? My wife had breast cancer... twice....each time the full boat...surgery, chemo, radiation, and follow up drugs. Did you all know it is mandated that all insurance covers reconstruction surgery following a mastectomy? Know the cost? $25,000 per ta...and there are two. And this time as a follow up Lee is on Faslodex for 8-10 years. Two shots a month...$6,800 per month. You do the math....a cool million over the ten years. A lot of cost....but a phenomenal value......taking three of our grandkids to dinner tonight. Without the treatment she has received I and our three sons and our nine grandchildren would have lost her years ago. Talk about a loss of value.

All this is very expensive, but it is the system we have built and are continuing to build. Do any of you think the future nano-tech, imuno this that and the other gene splicing therapy will cost less?? It is what it is and we either continue to progress towards longer and much better lives at more expense or we can retreat to the good old days and live our 42 years in some third world country free of drug costs, expensive insurance and long and involved clinical trials. I don't remember many Healing Well members from Afghanistan........just sayin'.

I cringe at the money I have put into health insurance, Medicare, co-pays, and deductibles. At least $125,000 in the last five years alone, let alone since my first paycheck 50 years ago. Unfortunately billions of people on this earth have not had the choice to do so. I'm glad I have.

Hats off to Todd and Mandy and all our brothers and sisters that are enjoying this evening because of the great value the greatest healthcare system known has provided. Thoughts and prayers to those who are struggling, we hope you all can thrive in any way possible.