To avoid producing vaccines that treat the wrong strains during flu season, the FDA should consider deferring some of its selections as well as other changes to the vaccine composition, according to a study by two decision analysts published in a journal of the Institute for Operations Research and the Management Sciences (INFORMS®).

“Repeated Commit-or-Defer Decisions with a Deadline: The Influenza Vaccine Composition” is by Laura J. Kornish of the University of Colorado and Ralph L. Keeney of Duke University. It appears in the current issue of Operations Research.

The researchers seek to help reduce the chances of problems like those seen in the 2007-2008 flu season, when two of the three vaccines prepared early in the year for millions of Americans failed to treat the flu strains that actually emerged at the height of flu season.

“There are two key takeaways from this research,” says Prof. Kornish. “First, that the FDA should be willing to consider deferring a decision about which strains to include if early, conclusive evidence isn’t available. This would mean accepting the proposition that identifying the right strain is worth waiting for, even if the supply produced won’t be sufficient. It may be better to have some of the right vaccine than a lot of the wrong vaccine.

“Second, the FDA should reexamine its commitment to the rigid structure of the vaccine, with exactly one strain from each of three categories. For example, if there’s agreement on choosing two of the strains and disagreement about which strain to pick for the third, why not include four?”

A key problem addressed by the researchers is how to deal with uncertainty in the process of choosing the flu strains for the vaccine. In February of every year, the FDA examines early evidence about flu strains circulating and selects three strains so that manufacture can begin and sufficient flu vaccine is available in the fall. By the time that production normally begins, though, it may not yet be clear which flu strain will be most menacing in October. This bind leaves officials to trade off between picking early, which may mean that there are sufficient supplies of vaccines whose effectiveness is limited; and picking late, leading to vaccine supplies that are insufficient to treat the needed population.

The decision to defer production on one or more of the strains makes sense, says Prof. Kornish, when there’s current uncertainty but confidence that more time will lead to more useful information.

For public officials, the authors acknowledge, deferring a decision brings pressure that may increase if additional information doesn’t arrive and they stick with an early proposal after sacrificing time that might have gone to vaccine production.

The authors developed their mathematical model to describe the repeated nature of the decision over time. It allows decision makers to make what-if analyses of vaccine production rates, severity of the flu, and effectiveness of the vaccines. Numerous sensitivity analyses of assumptions and parameters in the model provide insights for improved communication among those responsible for selecting the vaccines.

The problem resembles one faced by companies that market perishable products and products with limited seasons: when new products are developed specifically for an upcoming retail season, producers balance time spent deliberating about the best product with time spent producing the inventory.

About INFORMS

The Institute for Operations Research and the Management Sciences (INFORMS®) is an international scientific society with 10,000 members, including Nobel Prize laureates, dedicated to applying scientific methods to help improve decision-making, management, and operations. Members of INFORMS work in business, government, and academia. They are represented in fields as diverse as airlines, health care, law enforcement, the military, financial engineering, and telecommunications. The INFORMS website is http://www.informs.org.

http://www.scienceofbetter.org

Walgreens (NYSE:WAG)(NASDAQ:WAG) has enhanced its Prescription Savings Club to offer a 90-day supply of more than 400 generic medications for $12 - less than $1 per week. This list of value-priced generics, comprised of some of the most commonly prescribed medications, includes treatments for pain, asthma, blood pressure, cholesterol, diabetes, women’s health and much more.

Walgreens Prescription Savings Club, which launched last fall, also offers savings on more than 5,000 brand name and generic medications spanning every drug category, making it the most comprehensive drug savings program in the retail pharmacy industry. The plan was developed by pharmacists to cover treatments for common and chronic conditions, as well as preventive and lifestyle drugs not covered under many insurance plans, such as weight management, smoking cessation, family planning and sexual health.

“This club offers pharmacy patients exceptional value with its broad range of drugs covered, competitive pricing and superior convenience of our 6,300 locations,” said Walgreens senior vice president of pharmacy services Kermit Crawford.

One of the most important benefits of Walgreens Prescription Savings Club is that it allows patients to save on most, if not all, their medications at one pharmacy. Many patients are unaware of the safety risk involved with filling a generic at one pharmacy, an antibiotic at another and a brand name at a third. Using one pharmacy retailer allows pharmacists to screen more completely for dangerous drug interactions. Walgreens pharmacists can access a patient’s Walgreens prescription records no matter which location the patient uses.

“We’ve put together a truly complete solution that goes well beyond just offering good prices on a few drugs. We give patients the security and peace of mind of having all their prescriptions with one pharmacy that’s always nearby,” said Crawford.

Enrollment in the Prescription Savings Club is only $20 a year for an individual or $35 a year for families(1) - a cost many patients recoup with just one prescription filled under the plan. Anyone not receiving government-sponsored prescription coverage such as Medicare or Medicaid is eligible and no prior authorization is required.

The program has proven to be an attractive option not only for the uninsured, but anyone purchasing a medication not covered under their insurance plan. Savings will vary depending on the current cash price in a given area on a given day.

For example:

-An uninsured Walgreens patient who pays the club price of $12 for a 90-day supply of the generic diabetes drug metformin would typically save about $50.

-A Walgreens patient treating high cholesterol who pays a discounted club price of $45.97 for a 90-day supply of generic simvastatin would typically save about $115.

-A Walgreens patient treating seizures who pays a discounted club price of $140.53 for a 30-day supply of the brand-name drug Topamax would typically save about $33.

Walgreens Prescription Savings Club has seen a surge in enrollment in recent months as more patients become aware of the opportunity for significant savings.

“After my pharmacist printed out a list of prices for my prescriptions under the plan and I compared them side-by-side with what I was paying, joining the club seemed like a no-brainer,” said Walgreens pharmacy patient Edward Freeman of Miami Beach, Fla. “I’m glad I took the advice - I’ve already saved about $120 over the last three months.”

Walgreens Prescription Savings Club also covers hundreds of pet medications for substantial savings compared to prices found at many veterinarian offices.

In addition, club members receive a 10 percent reward on all Walgreens-branded products from OTC medications, baby care and household items to consumables. Rewards can be used toward any future Walgreens purchase (some exceptions apply). As the program continues to evolve, a number of other membership benefits will be added.

“We’re encouraged by the reaction to this program,” said Crawford. “People are facing challenging economic times, and we’re helping them save money without compromising the safety, service and convenience they value.”

For a complete list of medications covered under the program, go to http://www.walgreens.com/rxsavingsclub or visit your local Walgreens pharmacy.

Walgreens is the nation’s (USA) largest drugstore chain with fiscal 2007 sales of $53.8 billion. The company operates 6,356 drugstores in 49 states, the District of Columbia and Puerto Rico. Walgreens provides the most convenient access to consumer goods and cost-effective health care services in America through its retail drugstores, Walgreens Health Services division and Walgreens Health and Wellness division. Walgreens Health Services assists pharmacy patients and prescription drug and medical plans through Walgreens Health Initiatives Inc. (a pharmacy benefit manager), Walgreens Mail Service Inc., Walgreens Home Care Inc., Walgreens Specialty Pharmacy LLC and SeniorMed LLC (a pharmacy provider to long-term care facilities). Walgreens Health and Wellness division includes Take Care Health Systems, which is comprised of: Take Care Consumer Solutions, managers of 191 convenient care clinics at Walgreens drugstores, and Take Care Employer Solutions, managers of worksite-based health and wellness services at 355 employer campuses.

(1)This card does not constitute insurance. Membership fee of $20 per individual or $35 per family per year required. Persons enrolled in a publicly funded health care program are ineligible. Membership may be cancelled within 30 days of issue date.

http://www.walgreens.com/wcard

http://www.walgreens.com

View drug information on Topamax.

Global achievement of the health related Millenium Development Goals, the MDGs, depends largely on India’s success and on China accelerating progress even further, according to a new UNICEF report which examines the latest trends in child and maternal health.

In this year’s State of Asia-Pacific’s Children 2008, UNICEF says it is a “fundamental truth” that unless India achieves major improvements in health, nutrition, water and sanitation, education, gender equality and child protection, global efforts to reach the MDGs will fail. China too needs to make significant strides to regain early progress it made in child survival. In 2007 2.5 million child deaths occurred in these two countries accounting for nearly a third of all child deaths: India (2.1m) and China (415 000).

However the region’s robust economic growth, the fastest in the world since 1990, has lifted millions out of poverty. Child survival, regarded by UNICEF as a key test of a nation’s progress in human development and child rights, has improved considerably. But gains have been overshadowed by deepening disparities, which means health care often fails to reach the poorest. This is a region with half of the world’s children, spanning 37 countries and two hemispheres.

The report underscores a disturbing trend across the region: public health expenditure remains well below the world average on 5.1 per cent, with South Asia spending only 1.1 per cent of GDP and 1.9 per cent being spent in the rest of Asia-Pacific. In addition, as more services within countries are privatized and the government share of health budgets diminishes, public facilities become more run down and health workers leave for better paid jobs in the private sector or outside the country.

“The divide between rich and poor is rising at a troubling rate within subregions of Asia-Pacific, leaving vast numbers of mothers and children at risk of increasing relative poverty and continued exclusion from quality primary health-care services,” the report says.

Pneumonia, diarrhoea and malnutrition are the major causes of child death in the region. But vast inequities in income, geography, gender and ethnicity are essentially what stand in the way of children surviving and thriving.

The most fragile period for a child in Asia-Pacific is during the very first moments of life - if the baby is born without the help of a skilled birth attendant due to poor access or cultural practices, and if the mother is underweight, the chances of that baby staying alive becomes increasingly slim. In China most under-five child deaths occur within the first week of life, largely due to a lack of obstetric services. In India one out of every three women is underweight putting them at risk of having low birth weight babies and these babies are 20 times more likely to die in infancy than healthy babies.

South Asia is also the only sub-region in the world where female life expectancy is lower than male life expectancy and where girls are more likely to be underweight than boys. Pakistani boys are more likely to be immunized than girls and have better access to health care. “Unless discrimination against women and girls is addressed as part of overall strategies to improve child and maternal health, high rates of maternal and child mortality will remain stubbornly entrenched,” says the report.

Civil conflict also affects a child’s chance of survival — the two countries where a child has the hardest struggle to survive and thrive beyond his or her fifth birthday, are countries that experience ongoing conflict - Afghanistan and Pakistan. On the other hand despite the civil strife in Sri Lanka, that country has managed to cut child deaths by half since 1990, and stands out as a country that has budgeted well for children.

As the world has moved past the half way mark and into the final laps towards the Millennium Development Goals’ 2015 target line, what is needed now is political will and sound strategies to dramatically increase investment in public health services that specifically target the poorest and most marginalized.

Without improved health care, 13 of the Asia-Pacific countries will struggle to reduce the child mortality rates by two thirds. The Pacific has only managed to lower its under-five mortality rate by 22 per cent to 64 deaths per 1,000 live births - a far smaller reduction than recorded in other parts of the region. Despite overall strong performance in Southeast Asia, where on average the under-five mortality rate has been halved since 1990, wide variations between countries show that the poorest and least developed are still lagging.

The State of Asia-Pacific’s Children 2008 urges all governments, international agencies, non-government organizations, civil society and the private sector not to take for granted the recent gains but instead “consolidate and deepen” them by extending critical health services.

The report offers the following recommendations targeted to reduce child mortality further:

- to focus health resources on areas where the rates of child mortality are highest;
- to strengthen health systems by involving communities in preventative public health interventions;
- provide ongoing care from the beginning of pregnancy through the birth of a child and into adolescence;
- boost public health care spending by at least 2 percent (based on 2001 levels) to make quality public health care services affordable to the poorest people.
- tackle ongoing gender disparity by educating communities so they are better able to direct household resources towards the welfare of children.

About UNICEF

UNICEF works in over 150 countries and territories to help children survive and thrive, from early childhood through adolescence. The world’s largest provider of vaccines for developing countries, UNICEF supports child health and nutrition, safe water and sanitation, quality basic education for all boys and girls, and the protection of children from violence, exploitation, and AIDS. UNICEF is funded entirely by the voluntary contributions of individuals, businesses, foundations and governments.

http://www.unicef.org

The Food and Drug Administration announced several improved policies and procedures strengthening its management of FDA advisory committees. The improvements include stricter limits on financial conflicts of interest for committee members, improved voting procedures, and improvements to the processes for disclosing information pertaining both to advisory committee members and to specific matters considered at advisory committee meetings.

The policies and procedures are described in four final guidance documents, and proposed changes in policies are described in a draft guidance. The FDA announced the availability of the guidance documents in today’s Federal Register; copies of all of the guidances are available on FDA’s website. Most of the changes in the final guidance documents will go into effect immediately, and all are expected to be fully implemented within 120 days.

“The FDA’s regulatory decisions affect the health of millions of Americans, and we don’t make those decisions in a vacuum,” said Randall Lutter, Ph.D., deputy commissioner for policy. “It’s imperative that we seek advice from independent experts, and that we do so in a way that is public, open, and transparent. Today’s announcement strengthens our processes.”

FDA advisory committees are panels of independent, outside experts — often the world’s leading authorities in their fields — who advise agency officials as they consider regulatory decisions involving complex medical and scientific issues. Last year FDA convened 48 meetings of advisory committees on topics ranging from the safety of diabetes medications to the evaluation of new anticancer drugs for use in children.

Two of the guidance documents address FDA’s processes for evaluating and disclosing information about potential conflicts of interest and FDA waivers allowing participation in advisory committee meetings. Prior to each meeting, advisory committee members are screened by FDA staff to determine whether they have a potential financial conflict of interest, such as grants, stock holdings and contracts with a company that would be affected by the committee’s recommendations. Today, FDA is instituting a cap of $50,000 as the maximum personal financial interest an advisor may have in all companies that may be affected by a particular meeting. If an advisor’s personal financial interest is greater than $50,000, he or she will not be allowed to participate in that meeting. If less than $50,000, FDA officials may, in certain situations, grant a waiver, but will do so only if they determine that there is an essential need for the advisor’s particular expertise. Waivers, which include a description of the advisor’s personal financial interest and why the need for the expertise was essential, will all be posted on the FDA’s web site in advance of the meeting. FDA intends to use new templates for waivers and financial interest disclosure that will make them clearer and more consistent.

Another improvement addresses the public availability of briefing materials, the background information provided to advisory committee members in advance of a meeting. As detailed in the final guidance on advisory committee briefing materials, FDA intends to post briefing materials given to advisory committee members prior to a meeting on the FDA’s web site at least 48 hours before the meeting is scheduled to occur. The guidance document provides details on preparing and submitting documents to FDA for inclusion in the briefing materials, and also recommends a timetable that sponsors should follow when submitting such documents.

The agency also issued recommendations addressing the way that advisory committees will vote on questions, so as to avoid even the perception of any manipulation of votes. It is recommended that advisory committees use a process of simultaneous voting, in which all members vote at once. Previously, advisory committees sometimes voted sequentially, with the committee chair calling on each member individually and asking them to announce their vote aloud. Simultaneous voting avoids “voting momentum” in which some voters may be influenced, even subconsciously, by the votes of those who precede them. The agency also recommends that the results of votes be announced immediately in the meeting, and FDA intends to post on the FDA website a list indicating how each member voted. Any posted list will be part of the permanent record of the meeting.

FDA also proposed new criteria to clarify when the agency should refer a matter to an advisory committee. In some instances FDA is required by law to refer a matter to an advisory committee. In other instances, FDA would consider these new criteria when deciding whether to refer a matter to an advisory committee. The draft guidance being published for public comment is designed to make FDA’s advisory committee process more predictable and transparent.

The agency also has made improvements to the advisory committee web site to make it easier for users to access news on advisory committee meeting dates, agendas, financial disclosures and briefing materials.

Final Guidance on Procedures For Determining Conflict of Interest and Eligibility for Participation in FDA Advisory Committees

Final Guidance on Public Availability of Advisory Committee Members’ Financial Interest Information and Waivers

Final Guidance on Voting Procedures at Advisory Committee Meetings

Final Guidance on Preparation and Public Availability of Information Given to Advisory Committee Members

Draft Guidance on When FDA Convenes an Advisory Committee

Fact sheet summarizing all five of the August 2008 advisory committee guidance documents

Consumer Article: Strengthening the Advisory Committee Process

FDA Advisory Committee home page

http://www.fda.gov

There have been many protests about the 35% rise in fuel costs recently announced by British Gas.

It is not just the elderly who will suffer this coming winter. Spare a thought for the 10 million people in the UK who suffer from Raynaud’s phenomenon, a condition in which blood is prevented from reaching the extremities on exposure to the cold or any slight change in temperature. Without adequate heat a Raynaud’s attack may occur, in which the fingers and toes turn white, then blue and finally red when the blood flow is restored. This whole process is excruciatingly painful. Without heat there is a risk of developing finger ulcers, gangrene and at worst amputation of their fingers.

So how are these vulnerable people going to cope with their fuel bills? Probably only by heating certain rooms and this in turn can lead to greater problems as a Raynaud’s attack can be triggered by moving from a warm room into an unheated room.

There is no cure for Raynaud’s and treatments are inadequate due to the many side effects, so heat is the only way in which people who have the condition severely can survive. If you have Raynaud’s you need heat all the year round not just in the winter.

Anne Mawdsley MBE, Chief Executive of the Raynaud’s & Scleroderma Association and a sufferer of severe Raynaud’s says: “It is an absolute disgrace that British Gas are permitted to implement such a rise without giving thought to those who have a medical condition for which heat is their only way of alleviating the problem. Even last winter we were getting calls from people asking if there was any way in which they could get an allowance towards their heating bills. I dread to think what the coming winter will be like”.

The Raynaud’s & Scleroderma Association has a new leaflet containing Handy Hints on Keeping Warm and also a leaflet of tried and tested heating aids which are available. These can be obtained by sending an SAE to The RSA, 112 Crewe Road, Alsager, Cheshire ST7 2JA.

Raynaud’s & Scleroderma Association

The Washington Post on Sunday launched a series of reports examining the “lives of low-wage workers” based on a survey by the Post, the Kaiser Family Foundation and Harvard University. “Many struggle to pay for life’s basics — housing, food and health care — and most report having virtually no financial cushion should they stumble,” the Post reports.

For the telephone survey, 1,350 randomly selected low-wage workers were polled between June 18 and July 7. Low-wage workers were defined as adults ages 18 to 64 working at least 30 hours per week, not self-employed and earning $27,000 or less in 2007. According to the Post, nearly one-quarter of all U.S. adults meet the survey’s conditions.

The survey found that most low-wage workers have difficulties affording health care and housing. According to the survey, three in 10 low-wage workers are employed by companies that do not offer health insurance, and about four in 10 low-wage workers are employed by companies that do not offer sick days. More than half of low-wage workers said they have postponed necessary medical or dental care to reduce expenses, the survey found. About half of low-wage workers said they took the Earned Income Tax Credit last year, and about half of those with children said they received health care for their children through Medicaid or SCHIP (Fletcher/Cohen, Washington Post, 8/3).

While many express no opinion about whether presumptive Democratic presidential nominee Sen. Barack Obama (Ill.) or presumptive Republican nominee Sen. John McCain (Ariz.) would do more to improve the economy or health care, “Obama has the clear edge among those who picked a favorite on these core issues,” the Post reports. Overall, Obama holds a 2 to 1 edge over McCain in the poll among low-wage workers.

Seven in 10 low-wage workers said the federal government should focus on helping them find more affordable health care coverage, a “core component of Obama’s campaign,” according to the Post (Shear/Cohen, Washington Post, 8/4).

The survey is available online.

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

The New York Times on Sunday examined how U.S. “hospitals are taking it upon themselves to repatriate seriously injured or ill immigrants because they cannot find nursing homes willing to accept them without insurance.” The article is the second in a series, titled “Getting Tough,” that examines efforts by government and other organizations to coerce undocumented immigrants to leave the U.S.

According to the Times, newly arriving documented and undocumented immigrants qualify for emergency medical care only under Medicaid, which “covers only a small fraction” of costs. In most states, the government does not provide funding for post-hospital care for undocumented immigrants, temporary immigrants and documented immigrants who have been in the U.S. for less than five years. Under federal law, hospitals receiving Medicare funds must transfer or refer patients to “appropriate” post-hospital care, the Times reports. According to the Times, the “hospitals are operating in a void, without governmental assistance of oversight, leaving ample room for legal and ethical transgressions on both sides of the border.”

Some hospitals choose to turn these immigrants over to the care of their home country; however, some immigrant advocates “see these repatriations as a kind of international patient dumping, with ambulances taking patients in the wrong direction, away from first-world hospitals to less-adequate care, if any,” the Times reports. Some hospitals say the only alternative to deportation is to keep these immigrants in acute-care hospitals indefinitely. According to the Times, “Hospital administrators view these cases as costly, burdensome patient transfers that force them to shoulder responsibility for the dysfunctional immigration and health care systems.”

Lawsuit
The Times profiles Luis Alberto Jimenez, an undocumented immigrant who was injured in a car crash involving a drunk driver. Florida-based Martin Memorial saved Jimenez’ life twice. Then, after being unable to find a rehabilitation center willing to accept an uninsured patient, Martin Memorial cared for him for years at a cost of $1.5 million. The hospital then sought to return him to Guatemala, his home nation. Circuit Court Judge John Fennelly granted the hospital’s request to return Jimenez to Guatemala, which claimed it would provide care to him upon his return, the Times reports. Martin Memorial spent $30,000 for an air ambulance to transport Jimenez back to Guatemala.

The ruling later was overturned by the Fourth District Court of Appeals. The court said that there was no evidence to support that Guatemala would provide the appropriate care for Jimenez required under federal law and that Fennelly overstepped his bounds in a deportation issue that should have been handled by the federal government. According to the Times, “The decision has become what is known legally as a case of first impression on the issue of hospital repatriations.” Later appeals court rulings in Jimenez’ favor also ruled that the hospital can be sued for punitive damages and the cost of his medical care. The case is pending (Sontag, New York Times, 8/3).

A Times video related to the Jimenez case is available online.

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

The House on Friday voted 409-4 to approve a $118.7 billion fiscal year 2009 Military Construction-Veterans Affairs appropriations bill (HR 6599), CQ Today reports.

The legislation includes $72.7 billion in discretionary spending, an $8.8 billion increase from FY 2008 and $3.4 billion more than President Bush requested (Johnson, CQ Today, 8/1). Under the bill, VA would receive $47.7 billion in discretionary spending, a $4.6 billion increase from FY 2008 and $2.9 billion more than Bush requested (Sanchez, CongressDaily, 8/1). Before the passage of the bill, lawmakers proposed four amendments related to health care for veterans, three of which were withdrawn and one of which was denied a vote on a point of order (CQ Today, 8/1).

The White House on Wednesday said that Bush would veto the bill unless Congress finds $2.9 billion in offsets in other appropriations bills to meet the overall spending level he requested (CongressDaily, 8/1). However, “Democrats are determined to boost spending for key domestic priorities — and for veterans,” CQ Today reports. According to a Senate Appropriations Committee aide, the Senate plans to consider a different version of the bill (S 3301) in September (CQ Today, 8/1).

Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

© 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

The Democratic platform is “heavy on Obama’s message of change, a theme that helped him win his party’s nomination,” AP/Cleveland Plain Dealer reports. The drafting platform committee of the Democratic National Committee on Sunday also agreed to changes in its health care language, which include some recommendations by former Democratic presidential candidate Sen. Hillary Rodham Clinton (N.Y.), according to the AP/Plain Dealer reports. During the campaign, Clinton and presumptive Democratic presidential nominee Sen. Barack Obama (Ill.) advocated similar health care proposals, although Clinton supported a requirement that all U.S. residents obtain health insurance.

The committee agreed to include language in the platform that describes health care as “a shared responsibility between employers, workers, insurers, providers and government.” In addition, the platform states, “All Americans should have coverage they can afford,” adding, “While there are differing approaches within the party about how best to achieve the commitment of universal coverage, we stand united to achieve this fundamental objective through the legislative process.”

Michael Yaki, chair of the committee and an Obama aide, said, “There’s no real consensus yet on which is the best health care reform to do other than we are committed to universality and we’re committed to getting there,” adding, “We believe that as you make health care more affordable, people will be able to buy health care — that’s the basic principle. How we get there is a matter of the legislative process” (Sheeran, AP/Cleveland Plain Dealer, 8/3). Chris Jennings, a member of the committee and a former health care adviser to President Clinton, said, “It was important” that the language on “shared responsibility” was “stated quite clearly in the platform.” He called the changes to the platform on health care “an honorable accommodation that illustrates a commitment to unity.”

The full platform committee will vote on the platform in Pittsburgh on Saturday (Silva, “The Swamp,” Chicago Tribune, 8/3).

Editorials
Two newspapers recently published editorials about health care issues in the presidential election. Summaries appear below.

• Akron Beacon Journal: Obama has proposed to expand health insurance to more residents, as well as reduce health care costs, by the end of his first term as president, a plan that “invites full-blown skepticism,” a Beacon Journal editorial states. According to the editorial, Obama has proposed to reduce health care costs “primarily from promoting the use of electronic medical records, … controlling administrative costs … and emphasizing preventive care and the management of chronic diseases.” His “focus certainly is not misplaced,” but the “time frame for such a remarkable turnaround is overly optimistic” because of the “clash of political interests that have impeded an overhaul for more than a decade,” the editorial states. “More important still, there is little solid evidence the proposed changes will yield the size of estimated savings,” the editorial states, adding, “Slippery numbers only hurt the plan’s credibility” (Akron Beacon Journal, 8/4).
  
  
• Philadelphia Inquirer: Obama and presumptive Republican presidential nominee Sen. John McCain (Ariz.) both have “loaded up their crash carts with plenty of life-saving tools” and are “ready to apply the paddles to the heart of America’s ailing health care system,” but they likely will “discover that neither has developed a miracle cure,” an Inquirer editorial states. The editorial states, “McCain’s health plan, for instance, calls for dabbling a bit in experimental medicine, while Obama’s hopes could exceed his healing powers.” According to the editorial, both candidates “offer detailed strategies to deal” with the “array of complex challenges” faced by the U.S. health care system, with some agreement on “modernizing the health care system with greater use of technology, driving down drug prices through competition, targeting better prevention and management of chronic diseases, promoting quality care and coordinating patient care more closely,” which “bodes well for incremental reform.” The editorial states, “In terms of getting coverage to the uninsured, Obama appears to have the better plan,” but the proposal “could flop because it lacks a mandate that the uninsured actually purchase those newly affordable health plans.” The “remedy for Obama is easy: embrace a universal mandate for all Americans to buy health insurance, then find the means to help them purchase that coverage.” For McCain, the problem is that “his proposal to expand access to insurance seems bound to unnecessarily tick off the millions of people who have workplace insurance” and lacks “a solid answer for covering those Americans whose existing illnesses prevent them from finding insurance at almost any price,” the editorial states. The editorial adds, “McCain isn’t wrong to explore moving away from workplace-based health insurance,” but, “for his plan to work, McCain would have to embrace” a “more comprehensive approach.” The editorial concludes, “Both presidential candidates have to decide whether they’re really willing to follow through on the treatments they’re prescribing” (Philadelphia Inquirer, 8/3).

  Reprinted with kind permission from http://www.kaisernetwork.org. You can view the entire Kaiser Daily Health Policy Report, search the archives, or sign up for email delivery at http://www.kaisernetwork.org/dailyreports/healthpolicy. The Kaiser Daily Health Policy Report is published for kaisernetwork.org, a free service of The Henry J. Kaiser Family Foundation.

  © 2008 Advisory Board Company and Kaiser Family Foundation. All rights reserved.

A clear distinction should be made between ARE and the peaceful, legal activities conducted by the majority of animal rights organisations. Animal rights extremists want animal research to stop whether or not alternative research possibilities exist, and seek to force change through unlawful actions.

Besides acts of vandalism such as graffiti and damage or destruction of property, their action can include mass intrusions, abusive phone calls, theft, demonstrations at home addresses, cyber attacks, defamation, physical assault (although this is very rare), as well as allegations of product tampering.

The increase and the trans-border character of ARE should not be underestimated. EFPIA and its member companies share the general conclusions that there is a need for more coordination, collaboration and well-designed communication about this issue and are ready to support the competent authorities at EU and national levels to reduce the threat posed by a few criminal extremists.

Animal studies are a small but essential part of biomedical research, which results in modern vaccines, treatments and cures for patients, both human and animal. Together with other key stakeholders, the pharmaceutical industry is committed to implementing the ‘3Rs’ principle (refine, reduce and replace animal testing) by increasingly using in vitro, computer and imaging technologies, for example.

More information: http://www.animalresearchforlife.eu and http://www.efpia.eu

Today, the EU provides the best standards of protection for laboratory animals in the world through Directive 86/609. This legislation is currently under review to reflect scientific and technological advances that have taken place since its adoption 20 years ago.

About EFPIA

EFPIA represents the pharmaceutical industry operating in Europe. Through its direct membership of 32 national associations and 43 leading pharmaceutical companies, EFPIA is the voice on the EU scene of 2,200 companies committed to researching, developing and bringing to patients new medicines that improve health and the quality of life around the world.

EFPIA