The issue with Dendreon (DNDN) is not so much a patient demand problem as hesitancy on the part of prescribing physicians on reimbursement. This is an issue unique to Provenge because the entire $93,000 bill to the doctor's practice is due before they ever find out about reimbursement.
This is the first drug, to our knowledge, whose revenues are being affected by the cash flow statements of the prescribing physicians. Docs will only prescribe what they feel they can risk in their own practice's cash flows.
This will change, however, as reimbursment smooths. the Q-code issued July 1 will make a big difference as will the J-code to be issued January 2012. Both will dramatically smooth and, more importantly, SPEED reimbursement to doctor practices. This should remove considerable overhead from Dendreon's sales efforts.
I don't believe that physicians will be able to prevail from what I've seen insurance companies do from past exposures. Cash' I don't believe in this particular case that you will see any "smoothing out" for payment on this drug IMO. ( Talking in regards to Provenge). t