Dendreon Reimbursement Support:

We've got you covered

  • All Medicare Administrative Contractor regions cover PROVENGE based on the FDA-approved label
  • Plans representing approximately 99% of patients with private insurance cover PROVENGE based on the FDA-approved label

New: NCD and Q-Code

In 2011, CMS1 issued a National Coverage Determination (NCD) and Q-code for PROVENGE that simplify patient coverage criteria and expedite electronic billing and payment.

All Medicare Administrative Contractors cover PROVENGE, and reimburse for administration2, based on the FDA-approved label, per the NCD.

Download the latest guide for updated coding and billing instructions, with annotated forms to help minimize errors that can delay reimbursement:

Start PROVENGE Therapy

To start PROVENGE, and access scheduling and patient assistance resources, enroll your patients by contacting Dendreon ON Call.



Patient Assistance

Good News: 75% of patients receiving PROVENGE are expected to have minimal to $0 out of pocket costs. But for those with no coverage for PROVENGE, or who need help covering costs, Dendreon supports several patient assistance options, including:

 

1 Centers for Medicare and Medicaid Services
2 Administration reimbursement is retroactive for dates of service on or after June 30, 2011

IMPORTANT SAFETY INFORMATION

PROVENGE is intended solely for autologous use and is not routinely tested for transmissible infectious diseases.

In controlled clinical trials, serious adverse events reported in the PROVENGE group include acute infusion reactions (occurring within 1 day of infusion) and cerebrovascular events. Severe (Grade 3) acute infusion reactions were reported in 3.5% of patients in the PROVENGE group. Reactions included chills, fever, fatigue, asthenia, dyspnea, hypoxia, bronchospasm, dizziness, headache, hypertension, muscle ache, nausea, and vomiting. No Grade 4 or 5 acute infusion reactions were reported in patients in the PROVENGE group.

The most common adverse events (incidence ≥ 15%) reported in the PROVENGE group are chills, fatigue, fever, back pain, nausea, joint ache, and headache.

Please see the Full Prescribing Information.