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What New Cancer Pathway Programs Mean For The Drug Industry

New efforts by US payors suggest oncologics no longer enjoy the same protected reimbursement status they once did, potentially pulling the rug from under biopharma's hottest development, dealmaking, and revenue generating activities. To succeed in an increasingly competitive marketplace, biopharmas must adapt their strategies with an eye to reducing payors' overall costs.

By Ellen Foster Licking

The recent national coverage decision for Dendreon Corp.'s Provenge (sipuleucel-T) ought to be a wake-up call for the biopharma industry: there's no doubt US payors are taking a tougher look at the reimbursement of oncology products, a therapeutic area that has long enjoyed special status as a class "protected" from the strictures associated with less grievous diseases. Although it now seems likely the Centers for Medicare and Medicaid Services (CMS) will cover Dendreon's expensive prostate cancer immunotherapy in its FDA-approved indication, the fact that a coverage debate occurred at all suggests standards for oncology reimbursement are changing

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