What did Mark Twain say: Get the facts right, then distort them as much as you please.
Case in point: The WaPo piece on Provenge tinyurl.com/36pvsyn makes two major mistakes.. Actually three. Naw, make that four.
1. It gets the price of Provenge wrong. It is a vaccine that is administered three times at a retail price of $93k. Not $270K as cited in the article.
2. To suggest that the total price of the drug equals a quality adjusted life year (QALY) is absurd. The chart that goes along with the article is inaccurate and misleading. Moreover, a QALY is a rule of thumb developed back in 1985 to estimate the value of dialysis care for Medicare. To write as if $50K or $100K is a cutoff and a scientific one at at is misleading. Wrong on both counts then.
3. The article states: " In a study involving 512 patients with advanced prostate cancer, Provenge increased median survival from 21.7 months to 25.8 months." Way wrong and way misleading. There are patients who have lived for more than five years after Provenge. And as a legal brief from CareToLIve notes: " Appellee attempts to underwhelm the Court by stressing a 4.5 month “average” extension in survival to Provenge patients. That understates the effectiveness. Average is different from median. It’s an important distinction because misuse of the term "median survival" is one of the deceptive arguments used by those who are against Provenge approval (FDA). When anti-Provenge forces use the "average" terminology and attribute it to the median, they are undercutting the total Provenge beneficial effect. At the time of the committee meeting it is estimated that the actual average survival benefit in the 9901 trial was in the 10-12 month range, judging from the likely survival through Feb/Mar 2007 of 20 out of the 28 three-year survivors from 10/04. These 20 Provenge arm survivors would have lived anywhere from 5.5 to 7 years after their randomization between 1/00 and 10/01. underwhelm the Court by stressing a 4.5 month “average” extension in survival to Provenge patients. That understates the effectiveness. Average is different from median. It’s an important distinction because misuse of the term "median survival" is one of the deceptive arguments used by those who are against Provenge approval (FDA). When anti-Provenge forces use the "average" terminology and attribute it to the median, they are undercutting the total Provenge beneficial effect. At the time of the committee meeting it is estimated that the actual average survival benefit in the 9901 trial was in the 10-12 month range, judging from the likely survival through Feb/Mar 2007 of 20 out of the 28 three-year survivors from 10/04. These 20 Provenge arm survivors would have lived anywhere from 5.5 to 7 years after their randomization between 1/00 and 10/01.
4. And WaPo has yet to correct these facts. It did correct the name of the individual who got the Provenge math wrong.
And a bonus: It quotes Sean Tunis and Alan Garber without noting they both were on the Institute of Medicine committee setting comparative effectiveness priorities as well as recipients of CER dough. (If Garber had his way back in 1992, there would have been no new cancer or orphan drugs since he wrote then that the Orphan Drug Act allows the development of drugs that “do not meet traditional cost effectiveness criteria." See Benefits vs. profits: has the Orphan Drug Act gone too far? Pharmacoeconomics, 5:88- 92, 1994 and Gaucher Disease Edited by Anthony H. Futerman and Ari Zimran, Chapter 28.
Case in point: The WaPo piece on Provenge tinyurl.com/36pvsyn makes two major mistakes.. Actually three. Naw, make that four.
1. It gets the price of Provenge wrong. It is a vaccine that is administered three times at a retail price of $93k. Not $270K as cited in the article.
2. To suggest that the total price of the drug equals a quality adjusted life year (QALY) is absurd. The chart that goes along with the article is inaccurate and misleading. Moreover, a QALY is a rule of thumb developed back in 1985 to estimate the value of dialysis care for Medicare. To write as if $50K or $100K is a cutoff and a scientific one at at is misleading. Wrong on both counts then.
3. The article states: " In a study involving 512 patients with advanced prostate cancer, Provenge increased median survival from 21.7 months to 25.8 months." Way wrong and way misleading. There are patients who have lived for more than five years after Provenge. And as a legal brief from CareToLIve notes: " Appellee attempts to underwhelm the Court by stressing a 4.5 month “average” extension in survival to Provenge patients. That understates the effectiveness. Average is different from median. It’s an important distinction because misuse of the term "median survival" is one of the deceptive arguments used by those who are against Provenge approval (FDA). When anti-Provenge forces use the "average" terminology and attribute it to the median, they are undercutting the total Provenge beneficial effect. At the time of the committee meeting it is estimated that the actual average survival benefit in the 9901 trial was in the 10-12 month range, judging from the likely survival through Feb/Mar 2007 of 20 out of the 28 three-year survivors from 10/04. These 20 Provenge arm survivors would have lived anywhere from 5.5 to 7 years after their randomization between 1/00 and 10/01. underwhelm the Court by stressing a 4.5 month “average” extension in survival to Provenge patients. That understates the effectiveness. Average is different from median. It’s an important distinction because misuse of the term "median survival" is one of the deceptive arguments used by those who are against Provenge approval (FDA). When anti-Provenge forces use the "average" terminology and attribute it to the median, they are undercutting the total Provenge beneficial effect. At the time of the committee meeting it is estimated that the actual average survival benefit in the 9901 trial was in the 10-12 month range, judging from the likely survival through Feb/Mar 2007 of 20 out of the 28 three-year survivors from 10/04. These 20 Provenge arm survivors would have lived anywhere from 5.5 to 7 years after their randomization between 1/00 and 10/01.
4. And WaPo has yet to correct these facts. It did correct the name of the individual who got the Provenge math wrong.
And a bonus: It quotes Sean Tunis and Alan Garber without noting they both were on the Institute of Medicine committee setting comparative effectiveness priorities as well as recipients of CER dough. (If Garber had his way back in 1992, there would have been no new cancer or orphan drugs since he wrote then that the Orphan Drug Act allows the development of drugs that “do not meet traditional cost effectiveness criteria." See Benefits vs. profits: has the Orphan Drug Act gone too far? Pharmacoeconomics, 5:88- 92, 1994 and Gaucher Disease Edited by Anthony H. Futerman and Ari Zimran, Chapter 28.
