Can you put a price tag on the life of a prostate cancer patient?
With the advent of Provenge, the first-ever vaccine cancer treatment, that tag has been set at about $23,000 per month of life gained -- $93,000 in total for a treatment that extends life, on average, by four months.
Given already skyrocketing health care costs, the nearly-six-figure cost of Provenge has raised concerns among health care experts, but to those men who have benefited from this revolutionary new therapy, it's worth every penny.
"On a general basis, to survive is worth anything," says Bob Feutz, 84, of Redmond, Washington.
Feutz received Provenge in 2007 as part of a clinical trial after other hormone therapy and 38 sessions of radiation failed to control his prostate cancer adequately.
Provenge, unlike his radiation treatments, caused him nearly no side effects, just two short bouts of chills, during the three sessions needed. While his PSA level -- a test that helps gauge the presence of prostate cancer -- was over five before treatment, in the three years since it has steadily dropped to .69.
"I'm happy to be alive," he says.
Frank Notaris, a 77-year-old Brooklyn native, feels the same way. He just went through treatment a few months ago, but says that "if it keeps you alive, I think it's absolutely worth the cost. Hopefully the insurance companies will cover it."
But given the skyrocketing cost of health care, that cost, multiplied by the thousands of patients each year who could qualify for the treatment, raises concerns for some health policy experts.
The revolutionary technology responsible for the first vaccine for cancer treatment was 15 years in the making, says Mitchell Gold, president and CEO of Dendreon, the company that produces Provenge.
"It was a laborious process. We had to raise $1.2 billion to support the development. I think we've come up with a price that's acceptable. It's priced fairly for the value we're providing to the patients."
Gold says that the cost of Provenge was based on the "overall landscape" of treatment prices for cancer. More specifically, the comparable chemotherapy for advanced stage prostate cancer patients, Taxotere, ends up costing about $23,000 per month of life extended by the treatment.
This was used, in part, to set the price of Provenge -- four months, on average, of extended survival comes out to about the $93,000 price tag.
Given that Provenge only takes three sessions of treatment over the course of a month, and causes few side effects, Gold says it provides "increased value" when compared to chemotherapy, which takes months and causes fatigue, nausea, and other side effects.
But does setting the price on par with other similarly costly cancer treatments make it a "fair" price?
"Fairness has nothing to do with it," says David Howard, assistant professor in the department of Health Policy and Management at Emory's Rollins School of Public Health.
Because cancer treatment is usually covered by insurance, not the patient, pharmaceutical companies don't have to answer to the budgets of consumers when pricing.
"If they charge a million dollars that might be so ridiculous that it wouldn't be covered, but otherwise they have a pretty broad range," Howard says. This is one reason there has been a gradual uptick in the price of cancer treatments, he says.