AACE Defends Patient Release Rule
The American Association of Clinical Endocrinologists is defending a rule by the Nuclear Regulatory Commission that permits outpatient treatment using high doses of radioactive iodine. “We believe that the current rule has improved health care delivery by allowing more timely and convenient treatment of patients with thyroid cancer,” AACE President Bill Law Jr. wrote in a letter to the NRC. “In the past, the majority of patients … were hospitalized for therapy. … Unanticipated competition and conflicts in scheduling [the few beds available] often arose—leading to prolonged profound hypothyroidism in some patients. Outpatient scheduling has provided the flexibility to treat patients at an optimal time of their choosing.” AACE was responding to a petition by Peter G. Crane, a former NRC employee, to revoke the current rule, which allows patients to be released from radioactive isolation with more than the equivalent of 30 millicuries of I-131 in their systems. Mr. Crane, himself a former thyroid cancer patient, argued that letting patients receive outpatient radioactive iodine treatment exposes their families to harmful amounts of radiation. Outpatient therapy “means that patients who are sick, stressed, deeply hypothyroid, potentially nauseous, and highly radioactive are being sent out the door, where they may or may not come into close contact with loved ones and members of the public,” Mr. Crane wrote.
New Thyroid Trials Web Site
The American Thyroid Association has launched a Web site that lists ongoing clinical trials of treatments for thyroid diseases. The association is inviting patients to use the search engine at the site,
Enrollees Happy With Part D
A new survey of Medicare beneficiaries who are receiving Part D drug benefits finds them to be largely satisfied. The survey—conducted 10 weeks into the new coverage—was paid for by America's Health Insurance Plans, and conducted by Ayres, McHenry & Associates Inc., a Republican polling firm. The poll surveyed 408 of the 5.2 million people over age 65 years who have self-enrolled in Part D, and 401 of the 6.5 million “dual eligibles,” who were automatically enrolled because they had Medicaid drug coverage. Of those who self-enrolled, 66% said it had been worth the time and effort to enroll, and four-fifths (84%) said they had no problem signing up. The majority—85%–90% of both groups—said they had no problem using the new benefit. “This is a dramatic departure from the conventional wisdom about this program,” said Whitfield Ayres, a principal in the polling firm. But Ron Pollack, executive director of the advocacy group Families USA, said it was not surprising that beneficiaries who went to the trouble to sign up were happy. Shockingly few have signed up, however, said Mr. Pollack. “America's seniors are clearly voting with their feet,” he said.
Bill Seeks Consent for Off-Label Rx
A new bill in the California assembly would require doctors to get informed consent from their patients before “prescribing, administering, or furnishing” a prescription for off-label use. A failure to adhere to the requirement would be considered a violation of the Medical Practice Act, which means physicians could be charged with a crime. The California Medical Association opposes the legislation. In a statement, the CMA said existing law is enough because physicians can be held liable for not disclosing risks. AB 2856 was introduced by Assemblywoman Loni Hancock (D-Berkeley). It would require physicians to specify that a medication is not approved by the Food and Drug Administration for the use that the doctor is recommending, that the risks are unknown, and that there is not a consensus on the efficacy. A patient could withdraw consent at any time.
Patient/Doctor Decision Making
Decisions about medical treatment should be made by physicians and patients, according to a survey of 1,029 adults for the National Consumers League. More than 90% of respondents agreed that “all medications, both over-the-counter and prescription, offer benefits but also carry some risk of side effects. It should be up to physicians and patients to weigh benefits against the risks and to make decisions that are right for them.” The poll also found that the public strongly supports broader access to treatments—even those carrying additional risks—for chronic diseases such as multiple sclerosis, Parkinson's disease, and Alzheimer's disease. “Everything in life carries risks, but in the case of chronic, debilitating conditions, the greatest risk is a lack of new and improved treatment options,” said Linda Golodner, the league's president.
All Groups at Risk for Poor Care