Aetna, the third-biggest U.S. health plan, said Provenge is “medically necessary” for prostate cancer that has spread but not reached the liver in patients expected to live six months or more. Previously, Aetna’s insurance didn’t cover the drug for patients whose cancer had expanded to the brain or lungs, Susan Millerick, a spokeswoman for Hartford, Connecticut-based Aetna, said in an e-mail.
Aetna considers other uses, such as preventing prostate cancer and treating the disease if it hasn’t spread beyond the walnut-sized gland experimental, “because its effectiveness for these indications has not been established,” according to the insurer’s bulletin.
“Dendreon sees this as a positive policy update for patients with advanced prostate cancer who may be eligible for Provenge,” April Falcone, a spokeswoman for Dendreon, said in an e-mail.
Provenge, known medically as sipuleucel-T, was approved in April 2010 as the first therapy in the U.S. that trains the body’s immune system to attack cancer cells as if they were a virus. The treatment, which costs $93,000, was cleared for patients with advanced cases of prostate cancer after a three- year effort to gain regulatory backing.
About 241,740 men will be diagnosed with prostate cancer this year, and 28,170 will die from the disease, according to the National Cancer Institute.
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