I still find it curious how anyone can make the case that this particular drug has marginal efficacy?
Because I think you'd be hard pressed to find many onc drug with an HR>0.75 that made more than $1B/Yr in any given single indication (nsclc, HRPC, Pancreatic Cancer, ... ).
I think the two counter arguments are:
a) This ignores the simplicity and minimal side effects of Provenge. Although it isn't clear how much that is worth.
b) It ignores the lack of competition - HRPC doesn't, so far, have a lot of treatment choices. In which case Herceptin might be a good counter example (Herceptin is great example of the $ benefits of targeted therapy - putting the lie to big pharma's concerns that targetted therapies limits your market. It does - but it also limits your competition. Warren Buffett's moat.). But that may change in the next 5 years with all the interesting HRPC treatments in trials.