JustCare

Tag: Prostate cancer

  • Biden administration should lower price of prostate cancer drug, Xtandi

    Biden administration should lower price of prostate cancer drug, Xtandi

    In an opinion piece for StatNews, Peter Arno et al. explains how the Biden Administration could save the lives of thousands of people with prostate cancer. Specifically, they show how the administration could reduce the cost of the enormously high-priced drug Astella drug, Xtandi, by 66-80 percent using march-in rights. Naturally, at one-third to one-fifth its current cost of $156,000, many more Americans would be able to take advantage of the treatment than can do so today.

    Reducing the cost of Astella’s drug by two-thirds, let alone four-fifths, would mean that cost would not be a barrier to treatment for many more people with prostate cancer. And, the price reduction would be in keeping with what people in other wealthy countries pay for the drug. Why should Americans pay so much more for this drug or any drug for that matter?

    Americans already have paid for the research and development of Xtandi. It was discovered at UCLA with funding from the National Institutes of Health and the US Army. To use march-in rights, all Secretary of HHS, Xavier Becerra, would have to do is find that it is unreasonable to ask Americans to pay three to five times more than people in other wealthy countries for a drug that was developed with US taxpayer funding.

    Authority to reduce drug prices through march-in rights is well-established. There is no need for additional legislation. But Pharma has done a great job of keeping executive agencies from using this authority.

    To date, the NIH has rejected a petition for it to use march-in rights to reduce the price of Xtandi. The NIH position in 2016 was that it was not unreasonable for Xtandi to cost $156,000 in the US.  In fact, “any price” would be fine.

    A new petition was filed in 2019. Two years later, HHS sent the new request  to the NIH to consider. The Bayh-Dole Act of 1980 gives the federal government the right to address unreasonably high drug prices. It can allow third parties to manufacture a generic version of these drugs at lower cost.

    Medicare is covering Xtandi now at an unreasonably high price, spending more than $1 billion on it each year, at taxpayer expense. But, the price it is paying is obscene, driving up Medicare premiums and wasting taxpayer dollars. And, high copays and coinsurance for the drug still keep tens of thousands of people from taking advantage of it.

    What’s remarkable is that at the same time that the Biden administration says it supports legislation to lower drug prices that Congress can’t manage to pass, it refuses to take advantage of a generic version of Xtandi that Canada is willing to provide the US at 97 percent lower cost than what Medicare currently pays. The administration also claims it supports march-in rights. Actions speak louder than words.

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  • Should you be screened for prostate cancer?

    Should you be screened for prostate cancer?

    Prostate cancer is one of the leading causes of cancer death in the US. It is also the most common cause of cancer among men, according to the Centers for Disease Control. That said, most men survive prostate cancer. Virtually all men survive for several years, with 98 percent surviving for 10 years, and 96 percent surviving for at least 15 years. The five-year survival rate falls to 29 percent for men with prostate cancer that has spread to other parts of the body. Should you be screened for prostate cancer?

    Should you get a prostate cancer screening?

    The US Preventive Services Task Force (USPSTF) advises that men between the ages of 55 and 69 should decide for themselves whether to get a prostate-specific antigen (PSA)-based screening for prostate cancer. They should consult with their physicians about the risks and benefits and factor in their preferences in their decision.

    The USPSTF says that screening offers a small possible benefit of lowering the risk of death from prostate cancer for men between 55 and 69. It also says that screening can cause many harms, including extra testing and perhaps prostate biopsy, as well as overtreatment. Overtreatment can lead to incontinence and erectile dysfunction.

    As a result, the USPSTF gives the prostate cancer screening a “C” grade, meaning that there is “at least moderate certainty that the net benefit is small.” And, for men who are 70 or older, it gives the screening a “D” grade, recommending against it because “there is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits..”

    Why shouldn’t I get a prostate cancer screening?

    The Prostate-Specific Antigen (PSA) blood test cannot differentiate between cancers that will be aggressive and benign cancers that are slow-growing and will never produce symptoms. Even so, most people with prostate cancer (aggressive or otherwise), never have symptoms. Invasive treatments for prostate cancer, like chemotherapy and radiation, in people with a benign slow-growing form are likely to cause significant harm.

    The Prostate Cancer Foundation reports that as many as two in five men treated for prostate cancer had tumors that would never have presented a risk to their health or lives. But, the radiation treatment many men opt for can cause incontinence and erectile dysfunction. And, hormone therapy treatment can lead to depression and osteoporosis.

    On the other hand, screening could reduce the chance of death from prostate cancer. The medical community recommends shared decision-making around screening. Individuals should weigh the risks and benefits of screening and make an informed decision on whether to proceed.

    What does Medicare cover?

    If you decide to proceed with a prostate cancer screening, Medicare covers a prostate screening each year, including a Prostate-Specific Antigen (PSA) blood test and a digital rectal exam (DRE). If you have traditional Medicare and your doctor takes assignment, the PSA test is covered in full. If you are enrolled in a Medicare Advantage plan, it is also covered in full if you see an in-network doctor. You will be responsible for coinsurance or a copay with the digital rectal exam.

    Medicare covers these tests more frequently for people whose doctors say they are medically necessary for diagnostic purposes.

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  • More men at low risk for prostate cancer wait and see about treatment

    More men at low risk for prostate cancer wait and see about treatment

    An increasing number of men at low risk of developing prostate cancer are choosing a wait-and-see approach in lieu of treatment options such as radiation or surgery.

    In 2010, 14.5% of men with low-risk prostate cancer used a wait-and-see approach, also known as active surveillance. By 2015, that figure was 42.1%, according to new research published in JAMA. Over the same period, the rate of men in this group having their prostate gland removed declined from 47% to 31%, while those who received radiation therapy declined from 38% to 26%.

    Among men with intermediate risk, the active surveillance rate increased from 5.8% to 9.6% over the time period. The percentage of men in this group having either their prostate removed or having radiation only hardly declined. Among men with high risk, the rate of active surveillance remained the same, at about 2% over the period. Having a prostatectomy increased from 38% to 43%, while radiation therapy decreased from 60% to 55%.

    The results of the study are not all that surprising, considering that in 2010 the National Comprehensive Cancer Network changed its guidelines, recommending active surveillance for men at low risk or those with a short life expectancy.

    Prostate cancer is the second most common cancer among men worldwide. Last year, 1.3 million new cases were diagnosed.

    This article originally appeared in Medshadow.org

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