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Hi Linda,

I've been debating about the article for the PD newspaper--BTW is he the
fellow who asked you about "that gal out there in California," or some
such thing?  He never did get in touch with me--I've decided to take out
the worst of the Brownbach rhetoric, and make the political scope broader
to make it less specific, and to include all the obstacles that they
throw up in the way of research.  I know it's emotional and full of
rhetoric, but then that's it's power since I'm a patient and was a
caregiver--without the political outcry, I feel it wouldn't make sense.
I'll try to get it to you tonight or tomorrow, but I'm really pressed for
time.  Thank you for giving me the opportunity to voice my story.

Regarding DBS, couldn't Barbara reconsider surgery?  Is she so set
against it, or is she not a candidate any longer?  It's such a shame--I'm
sorry for you and your friend.  It was interesting to me that you had
those feelings about Millie and Mort Kondracke and Mike Fox, et al.;
money doesn't make PD more fun, but it sure makes the best of it, and a
whole lot easier.

Best,
Charlotte

On Wed, 12 Jun 2002 23:52:04 -0400 Linda J Herman <[log in to unmask]>
writes:
> Good news, but be aware it may still take over a year for the
> Medicare
> coverage process to be completed and nationwide coverage to begin
> (see
> below). The panel's recommendation is the first step - which began
> when
> a request for a national  Medicare coverage decision was filed by
> Barry
> Green, a PWP from Texas, in Oct 2001.
> SEE: www.grassrootsconnection.com  for more info. on this issue
>
> Medtronics Press release
> FROM:
>  Business Wire
>  June 12, 2002, Wednesday 02:56 PM Eastern Time
>
> SECTION: HEALTHWIRE
>
> DISTRIBUTION: Business Editors & Health/Medical Writers
>
> HEADLINE: Medicare Panel to Recommend National Coverage of Brain
> Stimulation for
> Parkinson's and Tremor; Clinical Data and Expert Testimony Highlight
> Benefits of
> Activa Therapy from Medtronic
>
> DATELINE: BALTIMORE, June 12, 2002
>
>   The approximately 2.5 million Americans with Parkinson's disease
> or
> Essential
> Tremor received good news today as a Medicare panel prepares to
> recommend
> national coverage for brain stimulation to treat advanced stages of
> the
> two most
> common neurological movement disorders.
>
>    After considering clinical data and expert testimony, the Medical
> and
> Surgical Procedures Panel of the Medicare Coverage Advisory
> Committee
> (MCAC)
> overwhelmingly affirmed the effectiveness of Activa(R) Therapy,
> which
> uses brain
> stimulation technology developed by Medtronic, Inc. (NYSE:MDT) to
> relieve
> symptoms of Parkinson's disease and Essential Tremor when medication
> alone fails
> to provide adequate benefit or consistently causes intolerable side
> effects.
> Based on the prevalence and progression of the diseases, as well as
> their
> responsiveness to medication, Medtronic estimates that about 85,000
> Parkinson's
> patients and 5,000 Essential Tremor patients in the United States
> are
> candidates
> for treatment with Activa Therapy.
>
>    "The panel's affirmation validates a growing accumulation of
> effectiveness
> data and, equally as important, the experience of thousands of
> patients
> whose
> motor function and overall lives have been dramatically improved
> through
> treatment with brain stimulation," said Dr. Erwin B. Montgomery, a
> movement
> disorders neurologist and co-director of the Cleveland Clinic
> Foundation's
> Functional and Restorative Neuroscience Center. "National Medicare
> coverage and
> adequate reimbursement are critical next steps in assuring access to
> this
> treatment for the thousands more patients who stand to benefit from
> it."
>
>    Dr. Montgomery addressed the MCAC panel with Dr. Roy Bakay,
> professor
> of
> neurological surgery at Rush-Presbyterian-St. Luke's Medical Center
> in
> Chicago.
> Their presentation noted key findings of a global clinical study of
> brain
> stimulation for advanced Parkinson's disease symptoms after one year
> of
> treatment:
>
>    -- 87 percent of patients, assessed without the benefit of
> medication,
>     demonstrated improved motor function
>
>    -- on average, patients gained an additional six hours of good
> motor
> function
> each day
>
>    Today's panel meeting at the Baltimore Convention Center also
> included
> discussion of a technology assessment report on Activa Therapy
> prepared
> by the
> Blue Cross and Blue Shield Association. "The published scientific
> evidence is
> compelling because of the numbers of consecutively treated patients
> described,
> the consistency of the findings across studies, and the magnitude of
> clinical
> improvements observed on standardized rating scales of neurologic
> function,"
> according to the report by Dr. Joan B. Vatz, who reviewed results of
> 33
> separate
> studies for the assessment. "More recent evidence suggests that
> bilateral
> deep-brain stimulation ... may alleviate ... parkinsonian symptoms
> (tremor,
> rigidity, and bradykinesia)."
>
>    MCAC's executive committee is scheduled to meet Sept. 25 to
> ratify its
> expert
> panel's recommendation. Following receipt of the executive
> committee's
> recommendation, the Centers for Medicare and Medicaid Services (CMS)
> will
> decide
> within 60 days whether to establish a national Medicare coverage
> policy
> for
> Activa Therapy. CMS will then publish its decision online at
> www.cms.hhs.gov/coverage/. If the decision is positive, CMS will
> issue a
> national coverage decision within 60 days and begin to develop
> implementation
> instructions for its contractors (carriers and fiscal
> intermediaries).
> These
> instructions will provide details regarding coverage, coding and
> reimbursement
> levels. Typically, it requires seven to nine months from the date of
> the
> national coverage decision for the policy to go into effect.
>
>    CMS (formerly the Health Care Financing Administration) is the
> government
> agency that administers Medicare and Medicaid, two bellwethers in
> health
> insurance that, combined, cover an estimated 75 million Americans.
> All 52
> Medicare jurisdictions now have written policies providing coverage
> for
> Activa
> Tremor Control Therapy, which stimulates the thalamus to suppress
> tremor.
> But
> less than half have written policies in place for Activa Parkinson's
> Control
> Therapy, which stimulates other structures -- namely, the
> subthalamic
> nucleus
> (STN) or the globus pallidus pars interna (GPi) -- to reduce the
> typically more
> debilitating symptoms of the disease, including stiffness and
> slowness. A
> national coverage policy for Activa Therapy would eliminate the need
> for
> individual action by the jurisdictions that do not have written
> policies
> for
> Activa Parkinson's Control Therapy.
>
>    Essential Tremor and Parkinson's disease are the two most common
> neurological
> movement disorders. Essential Tremor afflicts about 1.5 million
> Americans;
> Parkinson's disease, about 1 million. Tremor is a common symptom of
> both,
> but
> Parkinson's also causes rigidity, slowness of movement and poor
> balance.
>
>    Nearly 8,000 people in the United States have been treated with
> Activa
> Therapy -- about 6,000 for symptoms of advanced Parkinson's disease
> and
> another
> 2,000 for Essential Tremor. Activa Tremor Control Therapy received
> approval from
> the U.S. Food and Drug Administration (FDA) in August 1997 for
> unilateral
> stimulation of the thalamus to suppress tremor on the opposite side
> of
> the body.
> Activa Parkinson's Control Therapy received FDA approval in January
> 2002
> for
> bilateral stimulation of the STN or GPi to reduce symptoms of
> advanced
> Parkinson's disease. The cost of Activa Therapy ranges from $25,000
> to$30,000
> per side for the device and the associated physician and hospital
> fees.
>
>    Editor's Note: Additional information and graphics related to
> Activa
> Therapy
> are available online at www.activapresspage.com.
>
>
>
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