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Rep. Stupak Signals Willingness To Compromise On Abortion Coverage In Health Reform Legislation
Rep. Bart Stupak (D-Mich.) on Monday said that he and House Energy and Commerce Committee Chair Henry Waxman (D-Calif.) are negotiating to resolve the concerns of antiabortion-rights Democrats who want to exclude abortion coverage from the House health reform bill (HR 3200), Dow Jones reports. Stupak said that the compromise would affect how state abortion laws are handled under the bill (Yoest, Dow Jones, 7/20.). According to the AP/Atlanta Journal-Constitution, Stupak did not give details on the negotiations, and aides said that no final deal has been reached (Werner, AP/Atlanta Journal-Constitution, 7/21).Stupak said that he and Waxman"s staff discussed the compromise over the weekend. According to Stupak, a compromise could be voted on this week as an amendment during the committee"s markup of the bill. According to Dow Jones, Stupak holds a key vote on the health bill, which faces opposition from some other conservative Democrats on the panel over costs. His comments on Monday suggest "an easing of tensions" between antiabortion-right Democrats and supporters of the bill, Dow Jones reports. Stupak and 19 other House Democrats last week sent a letter to party leaders stating that they "cannot support a health care reform proposal unless it explicitly excludes abortion from the scope of any government-defined or subsidized health plan." They also stated that they want to ensure that a health benefits advisory council created under the bill "cannot recommend abortion services be included under covered benefits or as part of a benefits package." The advisory council would make recommendations to the HHS secretary, who would make final determinations on what public and private plans would be required to cover in a health insurance exchange. Stupak said that the two sides are "working in good faith" and that other members of the committee should not push their own abortion-related amendments (Dow Jones, 7/20). On Monday, committee voted 20-35 to reject an amendment, offered by Rep. Nathan Deal (R-Ga.), that would have eliminated a provision requiring states to adhere to minimum benefits requirements that employer-sponsored insurance must include. Deal said that states could be required to cover abortion or "out of mainstream" services. Stupak responded, "I hope we"re not going to start using reproductive rights as a red herring on every amendment that comes up." Panel Approves Sex Education AmendmentThe panel voted 33-23 to approve an amendment that would authorize $250 million through 2014 for "evidence-based" sex education programs for teenagers. Rep. Lois Capps (D-Calif.), who offered the amendment, said that abstinence-only programs would not be excluded if they are proven effective. Following debate on Capps" amendment, Rep. Lee Terry (R-Neb.) offered an amendment that would reauthorize the Title V abstinence-only sex education program. Committee Chair Henry Waxman (D-Calif.) said that Title V "has been a failure," adding that 25 states refused to accept the money through the program because it is ineffective. Terry"s amendment was rejected 26-29.The committee also voted 36-23 to adopt an amendment that would provide $150 million in grants through 2014 to state and local governments and not-for-profits for educating residents in "medically underserved" areas on various topics, including sexual behavior (Wayne, CQ Today, 7/21).

"What Must EPS Pilot Prove?" Asks NPA
The NPA is asking its members to utilise the new NPA IT forums website to comment on the criteria that should be used to demonstrate that EPS is operationally functional ahead of national roll-out. The NPA believes that EPS must work technically, be business and operationally functional, improve service delivery at pharmacies, and is safe for patients, before full roll-out can be contemplated. The website, http://itforums.npa.co.uk, provides an opportunity for members throughout the UK to voice their opinions on the IT programmes affecting their country or on general IT topics which affect all nations.
News of the day
Predicting Tamoxifen Resistance In Patients
Tamoxifen is a widely used and highly successful drug in the treatment of breast cancer, though resistance to tamoxifen is still a concern in recurrent disease (affecting 25-35% of patients), since therapy resistant metastatic tumor cells are a major cause of death. In a study in this month"s Molecular and Cellular Proteomics, researchers have uncovered a protein profile that may accurately predict whether a cancer will be tamoxifen resistant.
Diagnostics

MabThera Receives Positive Opinion In Europe For Treating Patients Whose Chronic Lymphocytic Leukaemia Returns

Roche announced that the European Union"s Committee on Human Medicinal Products (CHMP) has issued a positive recommendation for the use of MabThera (rituximab) in patients with relapsed or refractory chronic lymphocytic leukaemia (CLL). Physicians will soon be able to prescribe MabThera, the first monoclonal antibody therapy approved for previously untreated CLL, in combination with chemotherapy to patients who have been treated for the disease but whose cancer has returned or have not appropriately responded to therapy. This recommendation is based on the important results from REACH, the largest randomised clinical trial ever reported in previously treated CLL. These results showed that patients with relapsed or refractory CLL who received MabThera in combination with chemotherapy lived an average ten months longer without their disease progressing compared to those receiving chemotherapy alone (30.6 months vs. 20.6 months).1 MabThera is already approved for first-line use in previously untreated CLL in the EU and many other countries and, pending final approval by the EU authorities, physicians will be able to prescribe MabThera to those patients with relapsed or refractory disease. "MabThera has been shown to give patients significantly more time without their disease worsening compared to those receiving chemotherapy alone", said William M. Burns, CEO Roche Pharma. "The positive opinion will, therefore, be welcomed by doctors and patients alike as it represents hope for the future management of a disease that remains notoriously difficult to treat." CLL is the most common type of leukaemia in adults, accounting for approximately 30-40% of all forms of leukaemia in Western countries. Overall incidence of CLL is around three per 100,000 and is 30% more common in men than women2. The incidence of CLL is markedly increased in patients older than 65 with a median age at diagnosis of 72 years3. While CLL is generally considered a disease that is slow to progress, a significant proportion of patients have rapidly progressing forms of the disease. About REACH The REACH study is a randomised international study that included 552 patients with relapsed or refractory CLL. It was conducted at 88 study sites across 17 countries. The study was set up to investigate whether treatment of patients with relapsed or refractory CLL with MabThera in combination with chemotherapy (fludarabine and cyclophosphamide) was more beneficial than treatment with chemotherapy alone. The primary endpoint of the study was progression-free survival. About MabThera MabThera is a therapeutic antibody that binds to a particular protein the CD20 antigen on the surface of normal and malignant B-cells. It then recruits the body"s natural defences to attack and kill the marked B-cells. Stem cells (B-cell progenitors) in bone marrow lack the CD20 antigen, allowing healthy B-cells to regenerate after treatment and return to normal levels within several months. In oncology, MabThera is indicated: -- For previously untreated patients with CLL in combination with chemotherapy -- For the treatment of previously untreated patients with stage III-IV follicular lymphoma in combination with chemotherapy -- As maintenance therapy for patients with relapsed/refractory follicular lymphoma responding to induction therapy with chemotherapy with or without MabThera -- For the treatment of patients with CD20 positive diffuse large B cell non-Hodgkin"s lymphoma in combination with CHOP (cyclophosphamide, doxorubicin, vincristine, prednisolone) chemotherapy -- As monotherapy for treatment of patients with stage III-IV follicular lymphoma who are chemoresistant or are in their second or subsequent relapse after chemotherapy In addition, in rheumatology MabThera in combination with methotrexate is indicated for the treatment of adult patients with severe active rheumatoid arthritis who have had an inadequate response or intolerance to other disease-modifying anti-rheumatic drugs (DMARD) including one or more tumour necrosis factor (TNF) inhibitor therapies. MabThera is known as Rituxan in the United States, Japan and Canada. Over 1.5 million patient exposures with MabThera have been recorded worldwide since its launch. Genentech and Biogen Idec co-market Rituxan in the United States, and Roche markets MabThera in the rest of the world, except Japan, where Rituxan is co-marketed by Chugai and Zenyaku Kogyo Co. Ltd. About Roche Headquartered in Basel, Switzerland, Roche is a leader in research-focused healthcare with combined strengths in pharmaceuticals and diagnostics. Roche is the world"s largest biotech company with truly differentiated medicines in oncology, virology, inflammation, metabolism and CNS. Roche is also the world leader in in-vitro diagnostics, tissue-based cancer diagnostics and a pioneer in diabetes management. Roche"s personalised healthcare strategy aims at providing medicines and diagnostic tools that enable tangible improvements in the health, quality of life and survival of patients. In 2008, Roche had over 80,000 employees worldwide and invested almost 9 billion Swiss francs in R&D. The Group posted sales of 45.6 billion Swiss francs. Genentech, United States, is a wholly owned member of the Roche Group. Roche has a majority stake in Chugai Pharmaceutical, Japan. All trademarks used or mentioned in this release are protected by law. References: 1.SmPC REACH data submitted by Roche to EMEA [Roche data on file] 2.Watson L et al., Disease burden of chronic lymphocytic leukaemia within the European Union European Journal of Haematology 2008 ; 81(4), 253-258. 3.Ries LAG, Melbert D, Krapcho M, Stinchcomb DG, Howlader N, Horner MJ, et al. SEER Clinical Statistics. Review, 1975 - 2005. Bethesda, MD: National Cancer Institute;2008 Roche


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