CMS Plans To Pay For Provenge Mar. 30 2011 - 4:28 pm | 0 views | 0 recommendations | 0 comments By MATTHEW HERPER Investors in Dendreon have been waiting eagerly for news about whether the Centers for Medicare and Medicaid Services would pay for the company’s prostate cancer treatment Provenge.
Medicare has posted a draft of national guidance saying that it would indeed cover the product on a national basis because “the evidence is adequate.”
The Centers for Medicare and Medicaid Services (CMS) proposes that the evidence is adequate to conclude that the use of autologous cellular immunotherapy treatment – sipuleucel-T; PROVENGE® improves health outcomes for Medicare beneficiaries with asymptomatic or minimally symptomatic metastatic castrate-resistant (hormone refractory) prostate cancer, and thus is reasonable and necessary for that indication under 1862(a)(1)(A) of the Social Security Act (the Act).
We are requesting public comments on this proposed determination pursuant to section 1862 (l) of the Act. After considering the public comments, we will make a final determination and issue a final decision memorandum.
via Proposed Decision Memo for Autologous Cellular Immunotherapy Treatment of Metastatic Prostate Cancer (CAG-00422N).
There will be plenty of debate over the meaning of the fine print. Dendreon shares have already run up in advance of the decision. But this is good news for Dendreon and Provenge long term.