RE:RE:RE:My calculations add up to more than current sp !I can comment on this as we deal with this in the clinic that I work in.
Once a drug has an FDA approved indication it is now out there and can be ordered by any MD for any reason. However, they are not going to order for random things as doing that would be malpractice. The one scenario that would come up with Ruvidar approval is the indication would be BCG unresponsive NMIBC or BCG "intolerant" NMIBIC. In our clinic we have one condition for which one drug is cheap and work well and the other is a bit more expensive and works way better with much better dosing schedule. We game the system by prescribing drug #1 and telling patient that if they have stomach upset to let us know and we can prescribe drug #2 as it is covered if drug #1 is not tolerated. We give them one week supply of drug 1 and we wink wink when we give the the prescription. Ridiculous but drug #2 is that much better so we do it.
My point is that a patient could do one BCG round and have enough "side effects" that the urologist could move to Ruvidar with coverage quickly. One way to transition Ruvidar to being a first line agent of sorts over time.
I note that in the posters from earlier this year there were a few patients who got barely any BCG so there is a precedence of some patients not tolerating it and going to next option.