Private payers mull restrictions on Provenge

How are insurers likely to treat Dendreon's (NASDAQ: DNDN) new prostate cancer vaccine Provenge? Very carefully, at least according to a new survey from Reimbursement Intelligence. Some 65 percent of national and regional insurers said they may somehow restrict patient access to the pricey vaccine.

As Pharmalot reports, three-fourths of the survey respondents expected to require prior authorization, sometimes including documented use of other therapies. Almost half wouldn't pay for Provenge for patients who hadn't had chemotherapy first. More than half would only provide the vaccine to patients whose cancer had metastasized.

Now, these restrictions aren't likely to make much difference for awhile. Dendreon is turning out only a small amount of Provenge right now. It's ramping up manufacturing as quickly as possible, but expects that process to take many months. Supply is expected to fall short of demand for at least 12 months; two new plants are slated to be up to speed by the end of next year.

- see the Pharmalot piece

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