That sounds plausible, but Dendreon also blamed its new woes on the inability of doctors to identify patients in their practice who are eligible for Provenge. Often, the company says, doctors don't screen prostate cancer patients until it's too late and their prostate cancer has advanced to the point where using Provenge becomes impractical or more difficult to justify reimbursement.
OK, but spun another way Dendreon's explanation could easily be construed as doctors being skeptical about Provenge's efficacy and survival benefit claims, thereby not bothering to push Provenge to patients even if they're eligible. Or patients, even when presented with the option of Provenge treatment (and told about the high cost) are saying "No, thanks."
Expect the debate about Provenge reimbursement issues versus patient demand to continue in the absence of real numbers from Dendreon.
ISI's Schoenebaum emailed clients Wednesday night the following on Provenge patient demand:"This is actually the single most important question as it relates to the stock, of course. My basic view at this point is that the revenue miss and guidance revision reflected BOTH demand related problems and logistical/perceptual reimbursement issues. We have all spoken to doctors that have worried about reimbursement. However, we've also all spoken to doctors that just aren't all that enthusiastic about the clinical profile of Provenge. In addition, the company did say on its call that doctors aren't identifying many patients in their practices that are, indeed, eligible for Provenge. Given that the labeled patient population is easy to identify, we viewed this as an (unintentional?) admission by the company that there is a demand problem. And therein lies the greatest risk to our new model: Even though we now model what seems to be very modest growth (only about $1M/month), what if that just doesn't happen?? We'll have to keep a close eye on this, but admit that we know of no reliable way to monitor real time Provenge demand.
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