provenge update

Thank each of you for your posts,
My thoughts. Yes 4.1 months median survival is true but the operative word is median. Half died before. Half died after. Some went into a remission that has not ended. I find it ironic that an insurance company would say it does not work for people under 65. Why don't they just say it doesn't work for people until they are on medicare because we won't pay for it and medicare will. It's like that in so many arenas of life. You can have anything you want if you can afford to pay for it. I have worked hard my whole life. My wife and I do okay. We average 100k a year. We are not rich. She is a medical assistant and I am a Journeyman Pipe fitter. I pay $300.00 a month for my health insurance which is 25% of the total policy cost. There are 1200 people who work at my plant. My fellow employees and I, along with my employers contribution, send a check to my h.m.o. for $1,440,000.00 every month. $17,280,000.00 every year. We are one company in a huge h.m.o. Insurance companies are taking it to us people. We are not stupid but they sure pull the wool over our eyes. Provenge trials were done among the sickest of the sick. They had ran the gauntlet of treatments and were at the end of their rope. Their immune systems had been subjected to every kind of poison the doctors could throw at them. Imagine what could be done with a healthy immune system. Oh dear that there provenge shor costa lotta money. Four months is not worth 94k. Thats true. It's not. We have other back -up treatments though. Is 2 and 1/2 years of side effect free treatment worth 94k. Toddy say yes. Then they can start with the poison and the side effects and the radiation and all the wonderful stuff I get to look forward to. Just my thought people. Todd

It is a thought I have toyed with. Mind you they have not come out and said straight up we wont cover it. It is an implied read between the lines kind of thing. I will play their games and jump through their hoops like a good dog but if the rubber meets the road and they say flat out no then they best prepare themselves for a ****storm.

http://www.provengereimbursement.com/patient-assistance.aspx

Support for Patients Without Coverage for PROVENGE

For eligible patients who do not have coverage for PROVENGE, Dendreon provides drug free of cost**
In the event an eligible patient's claim for coverage for PROVENGE is denied by his payer after all appeals, the cost of the drug may be covered by Dendreon's patient assistance program
Eligibility criteria include:
A household adjusted gross income of $150,000 or less
United States residence
On-label prescription for PROVENGE

Ein you are cool man. Really. Todd

Todd:

I'm confused. You got this vague no-sounding but not definitive response.

WILL YOU BE GETTING A DEFINITIVE RESPONSE ?

Did they tell you when to expect such a response.

Mel

Saturday morning still no news. Sucky

Sunday feb 26. My sweethearts birthday. Sad to say but I have a vivid memory of the day she was born. I hope I get some answers tomorrow. One way or another tomorrow my fight will begin. I hope it is against the cancer and not my H.M.O. Today is about my Honey and Mexican food, Margaritas, and cake. Peace...... Todd

Fighting my hmo. They say it wont be affective in me because I am too young. I filed an appeal and also an appeal for a second opinion and should hear something tomorrow. I have done the best I can and if nothing comes of it I will try zytiga I suppose.

I still have my fingers and toes crossed that you get in and on the schedule as soon as possible, waiting is so miserable, even when you PSA isn't rising. Keep the faith that it will happen and it will help you get to your 30 years that you want. I just got my last PSA result late last week and still non-detectable. Everyone is stumped, I shouldn't be, so hopefully Provenge was part of the answer. Time will tell if the four treatments made a difference in my outcome. I can't wait until you are on my side, had the treatments and to hear good news that your PSA is screaming down to crash and burn all those darn cancer cells.

Hang in there, We are all rooting for you.

Best Regards

Todd,

Sorry for all the questions, but this seems outragious.

Did your doctor give that excuse or is that the official written reason from the insurance company?

If this is a fact, the doctors of all young PC patitents need to understand.

Put the pricetag aside. Does your doctor still want to go that route?

Hang in there. You are not going to be fighting this alone.

The key is that with a measurement of all under the age of 65 there was significant benefit for this patient class. It was interesting to see this process and how even doctors can misuse data from a Level 1 study. 9902b was not designed for the way that your carrier was intending to use it. It was designed to verify the overall survival benefit for the entire cohort. The subclasses were just a measuring stick that they wanted to acquire additional data on. I am not even certain that there was no subclasses and that the reviewer was doing his own retrospective analysis. I see even more now why there are many flaws to retrospective studies and that the holes that are left uncovered in them are highly controversial. But using the retrospective approach to grab data from one Level 1 study can be over turned by the use of retrospective data from two other level 1 studies. Simply put the patient class of under 65 participants was far too small to arrive at usable data and it likely is quite subject to chance given the small cohort. Over the three studies, this class saw a significant benefit for the under 65 crowd...

Tony

It would seem to me that the Provenge folks would want younger guys, presumably in better health than some of the older folks--- no disrespect intended, to receive the therapy so they could see if the treatment has legs. If Todd or someone in a similar situation gets the treatment and ends up surviving 10-20-30 more years with no additional treatments, that would be a boon to the overall treatment of the disease AND the Provenge folks. And it could lead to being used instead of some of the frontline treatments presently used. Moreover, 90K has to be a lot less than RP, Seeds, SRT, HT, Radiation, and Chemo over a 10 to 20 year period.