Most urologists are not affiliated with academic centers much less the centers where the clinical trials for Provenge were conducted. That being said, the majority of prostate cancer is diagnosed by these community urologists. Dendreon has indicated that they will directly market to urologists.

Most urologists do not give IV medication in their office. There are many reasons for this, but the main one is that the time and staffing required is not worth the reimbursement.

So, in order to have their patients get Provenge, will urologists have to refer patients to medical oncologists? Will they have to refer patients to academic centers?

Actually, I don't think so. I was talking to an oncologist the other day. His practice has an infusion center and he says that there are doctors in other specialties who will use his infusion center to administer IV medications. The oncology practice will receive the fee for the infusion. The other specialty will receive the fee for the purchase and giving of the medication to the patient.

I can easily see myself in the future using this model (having a mutually beneficial relationship with an infusion center) for patients who can benefit from Provenge.