The ‘Best Hospitals’ for 2009

Hospitals are listed below by total points. Here are the 21 hospitals that made the magazine’s honor roll (two are tied for 10th place):

1. Johns Hopkins Hospital, Baltimore
2. Mayo Clinic, Rochester, Minn.
3. Ronald Reagan UCLA Medical Center, Los Angeles
4. Cleveland Clinic
5. Massachusetts General, Boston
6. New York-Presbyterian University Hospital of Columbia and Cornell
7. University of California-San Francisco Medical Center
8. Hospital of the University of Pennsylvania, Philadelphia
9. Barnes-Jewish Hospital/Washington University, St. Louis
10. Brigham and Women’s Hospital, Boston
11. Duke University Medical Center, Durham, N.C.
12. University of Washington Medical Center, Seattle
13. UPMC-University of Pittsburgh Medical Center
14. University of Michigan Hospitals and Health Centers, Ann Arbor
15. Stanford Hospital and Clinics, Stanford, Calif.
16. Vanderbilt University Medical Center, Nashville, Tenn.
17. New York University Medical Center
18. Yale-New Haven Hospital, New Haven, Conn.
19. Mount Sinai Medical Center, New York
20. Methodist Hospital, Houston
21. Ohio State University Hospital, Columbus

Top Hospitals by Specialty

Here are the No. 1 hospitals in each specialty, according to U.S. News and World Report:

• Cancer: M.D. Anderson Center, University of Texas, Houston
• Diabetes and endocrine disorders: Mayo Clinic, Rochester, Minn.
• Digestive disorders: Mayo Clinic
• Ear, nose, throat: Johns Hopkins Hospital, Baltimore
• Geriatric care: Ronald Reagan UCLA Medical Center, Los Angeles
• Gynecology: Brigham and Women’s Hospital, Boston
• Heart and heart surgery: Cleveland Clinic
• Kidney disorders: Brigham and Women’s Hospital
• Neurology and neurosurgery: Mayo Clinic
• Ophthalmology: Bascon Palmer Eye Institute, University of Miami
• Orthopaedics: Mayo Clinic
• Psychiatry: Massachusetts General, Boston
• Rehabilitation: Rehabilitation Institute of Chicago
• Respiratory disorders: National Jewish Hospital, Denver
• Rheumatology: Johns Hopkins Hospital
• Urology: Johns Hopkins Hospital

Information is from US News and World Report

Milwaukee cases to be key in developing swine flu vaccine

By Mark Johnson of the Journal Sentinel

Posted: July 25, 2009

To better understand the enemy they will face this fall, health investigators have been studying Milwaukee’s swine flu outbreak during the spring and following the virus as it sweeps through the Southern Hemisphere.

Two important questions remain elusive:

How severe is the H1N1 influenza? And why were there so many cases in Milwaukee this spring and summer?

“The hardest and, globally, the most important question, is the severity,” said Marc Lipsitch, a professor of epidemiology and director of the Harvard School of Public Health’s Center for Communicable Disease Dynamics.

Lipsitch, who is leading the Harvard study of Milwaukee and a handful of other communities around the nation, said it may be difficult to quickly pinpoint the virulence of swine flu. Researchers hope to know enough about the virus to prepare rough estimates for a fall outbreak, including what fraction of the infected will need to be hospitalized, what fraction will need to be treated in intensive care units and what fraction will die.

“Individual hospitals around the country could have three to five times as many influenza admissions. That’s probably the high end,” said Chris Ohl, an associate professor of infectious diseases at the Wake Forest University School of Medicine.

What made Milwaukee so useful to researchers is that the city continued counting even mild flu cases while other cities gave up tallying the mild cases. That presented a problem when it came to calculating the severity of H1N1.

Without having an accurate picture of the total number of people infected - both severely and mildly - researchers cannot say with certainty what percentage of the infected has been hospitalized and what percentage has died. This may explain why the virus appeared to be more severe in Mexico; many mild cases are believed to have gone undetected, making it appear as though the deaths accounted for a high percentage of all cases.

Although health officials in Wisconsin have stressed that aggressive surveillance and testing explained why the state led the nation in confirmed swine flu cases, Lipsitch suggested that does not explain fully the high flu numbers here. Wisconsin still has 1,000 more confirmed swine flu cases than any other state, with 6,222, according to the Centers for Disease Control and Prevention. Texas, the next highest state, has 5,151.

“Milwaukee, Boston and New York all had significant epidemics,” Lipsitch said, explaining for comparison that “in Atlanta there was just no evidence of serious transmission.”

One theory is that northern communities saw some of the highest flu numbers because the virus fares better in cold, dry weather.

Based on what has been learned so far, it appears likely that Milwaukee and other communities around the nation will conduct mass vaccinations for the novel H1N1, possibly by mid-October or November. Also, it is likely that the priority groups in line for vaccinations will differ from those in the past, skewing less toward the elderly and more toward younger people with underlying health conditions, such as asthma, emphysema and obesity. Pregnant women and school-age children are likely to rank among the high-priority groups as well.

Harvard School of Public Health investigators have examined documents on a few hundred flu cases in Milwaukee. So far, they have learned that early use of the anti-viral medication Tamiflu appears effective in stopping the flu from spreading through households.

Vaccine strategies

Paul A. Biedrzycki, Milwaukee’s director of disease control and environmental health, said the Harvard team has examined state communicable disease reporting forms for 200 to 300 swine flu cases, looking at such factors as age, gender, underlying medical conditions, use of anti-viral medications and geographical location within the city. He said this information could help officials to devise a vaccination strategy, so that “if there are limited supplies of vaccines, we know where they might be best targeted.”

The Milwaukee flu data may also help officials determine whether anti-virals will help stop transmission of the virus not only in households but in other settings, including schools.

Biedrzycki said the swine flu could change while it is in the Southern Hemisphere or later on.

“I think we’ll see changes in the fall, but also farther down the road,” he said. “We need to be prepared for many iterations of this virus.”

He said health investigators also will want to determine if there are so-called “super spreaders” who can infect many people.

The Centers for Disease Control and Prevention in Atlanta and other health organizations are watching swine flu closely in the Southern Hemisphere, where flu season began in early May and is expected to peak at the end of August. They worry that the virus may be altered during its run through the Southern Hemisphere, possibly becoming more virulent, developing a resistance to Tamiflu or changing the speed and method of transmission (for example spreading through fecal matter).

Joe Quimby, a senior press officer at the Centers for Disease Control and Prevention in Atlanta, said the CDC has had staff on the ground in different countries in the Southern Hemisphere watching what has been happening with swine flu virus.

So far, Quimby said, “No changes have been identified in the genetic makeup of the virus. What we’ve seen thus far is that it’s brisk in the Southern Hemisphere, it’s very active and it is the predominant strain.”

If H1N1 returns to the Northern Hemisphere as the predominant strain, that could alter significantly the nation’s flu-fighting strategy.

Ohl at Wake Forest explained that flu vaccines usually are prepared a year in advance and have three components. That’s because there are usually two or three different types of flu circulating at the same time. But the presence of H1N1 in the mix raises questions.

“Will there be four viruses circulating or will it take the place of one of the viruses?” Ohl wondered. “Or will it just take over and push the others out of the way?

“What it looks like so far in the Southern Hemisphere is that the novel pandemic swine flu has basically taken over and is by far the predominant strain.”

If swine flu does become the predominant strain during our flu season, Ohl said, “our seasonal flu vaccine won’t be as useful, and it will be much more important to get H1N1 vaccine.”

The first human trials of swine flu vaccine got under way this week in Australia. The trials are to make sure the vaccine is safe and effective. Ohl said the trial process takes a few months, meaning that a vaccine could be ready by October or November.

“It looks like it will be a just-in-time scenario,” Ohl said.

Swine Flu Vaccine: When?

Swine Flu Vaccine Timeline: Key Decisions, Key Milestones

By Daniel J. DeNoon
WebMD Health News

Reviewed by Louise Chang, MD

July 20, 2009 — Pandemic swine flu doesn’t worry most Americans. That’s likely to change very quickly.

Well before fall 2009, most U.S. schools will open. That’s when experts warn the second wave of the pandemic may start sweeping the U.S. If that happens, the U.S. — as well as the rest of the world — needs to be prepared for the worst. A pandemic that sickens millions could close schools and businesses, halt travel, and overwhelm health care facilities.

“A pandemic is much more than a health event,” Bruce Gellin, MD, MPH, director of the National Vaccine Program Office and deputy assistant secretary of the Health and Human Services Department (HHS) to coordinate U.S. vaccination efforts, tells WebMD. “Given the way a pandemic could play out, it has consequences across government and across society.”

The best defense: A vaccine to protect people from swine flu — before the pandemic peaks. Will there be a vaccine? Perhaps not that soon. And the clock is ticking away the short amount of time before federal officials, including President Barack Obama, have to make hard choices about whether — and how fast — to get swine flu shots to everyone who wants one. Or at least to those who most need one.

One choice already is made: The U.S. government has spent $1.15 billion to buy enough vaccine to immunize the entire U.S. population against the new flu. If the government makes the decision to go ahead with a full-scale vaccination program, it would be the largest, fastest vaccination program in world history.

So what will happen, and when? Here’s WebMD’s timeline, based on meetings and interviews with a number of flu experts. Warning: Flu viruses — and flu vaccine production — are notoriously unpredictable. Many things can change, even by the earliest points of this timeline.

July

Making and Testing the Swine Flu Vaccine

Pandemic swine flu vaccine is already rolling off the production lines of the five different vaccine makers supplying the U.S: 46% will come from Novartis, 26% will come from Sanofi Pasteur, 19% will come from CSL, 6% will come from MedImmune, and 3% will come from GlaxoSmithKline.

By mid-July, clinical tests of the vaccines sponsored by the National Institute of Allergies and Infectious Diseases will begin at the eight Vaccine and Treatment Evaluation Units at Baylor College of Medicine, Houston; Children’s Hospital Medical Center, Cincinnati; Emory University, Atlanta; Group Health Cooperative, Seattle; Saint Louis University; University of Iowa, Iowa City; University of Maryland, Baltimore; and Vanderbilt University, Nashville, Tenn.

The five vaccine manufacturers will also start separate clinical tests in the U.S., Australia, and Europe. These tests will begin in July and August.

On July 29, the CDC’s vaccine advisory committee will vote on who should be first in line to get the vaccine. Current indications suggest that children 0 to 4 years old will be will be at the top of the list, followed by school-age children. Children with asthma and pregnant women are also likely high-priority groups, as are critical emergency-response workers.

Preparing the Country for the Swine Flu Vaccine

Beginning with the July 9 Flu Summit, federal health officials stepped up work with state and local officials to lay the groundwork for a massive immunization effort. HHS Secretary Kathleen Sebelius has pledged $7.5 billion in preparedness funds and $350 million in direct grants to states and territories.

August

Administer Vaccine Now or Later?

By mid- to late-August, seasonal flu vaccine — the normal, three-in-one vaccine against seasonal flu — will start arriving. The CDC will recommend people get their flu shots or flu sniffs earlier than usual this year, to make way for possible pandemic flu vaccination.

If there seems to be a huge increase in pandemic flu cases, officials will be tempted to trigger vaccine delivery before safety and efficacy studies are completed.

Would that be safe? The pandemic swine flu bug is a type A H1N1 virus. One of the seasonal flu bugs is a type A H1N1 flu bug. Seasonal vaccine doesn’t protect against the new swine flu bug. But there’s a long history of safety and efficacy for flu vaccines made of H1N1 antigens, notes flu expert John Treanor, MD, chief of infectious diseases at the University of Rochester, New York.

“You might be sitting at the end of August faced with the decision to do this,” Treanor tells WebMD. “If we wait, we can’t do vaccination until November. If the pandemic flu follows the seasonal-flu pattern with the bulk of activity in January through March, fine. But if we see this second wave coming in September, we might be faced with the decision to do vaccinations without clinical data.”

An HHS advisory committee on July 17 strongly recommended that Sebelius give the green light to vaccine production by Aug. 15 — before safety and dosing tests are finished. That would mean 60 to 80 million vaccine doses could be ready by Sept. 15.

How fast pandemic flu vaccine gets to people depends on the decision whether to give the vaccine in the traditional way or with something called an adjuvant.

A vaccine includes a piece of virus that evokes a flu-specific immune response. It’s called a flu antigen. An adjuvant boosts immune responses to the vaccine and could make the antigen supply go four times as far, allowing the U.S. to share some of its vaccine with the rest of the world. Adjuvant may also elicit broader immune responses, which would be very important if the swine flu virus’s genetic code “drifts” a bit before the next pandemic wave.

Vaccinating all Americans would be an effort of historic proportions.

“This would be the largest vaccine drop that has ever happened in the world,” says Robin Robinson, PhD. Robinson is the director of the Biomedical Advanced Research and Development Authority (BARDA), the HHS authority that makes sure the nation has the biomedical supplies it needs for emergencies.

“The most we’ve ever done for seasonal flu vaccine is about 120 million doses in 75 days,” he tells WebMD. “At this point, with an antigen-alone pandemic vaccine, we would see about 160 million doses in 30 days. If we go with adjuvant it could be over 300 million in 30 days — and more coming back behind it.”

Making Sure the Vaccine Is Safe

The most important question about a pandemic flu vaccine is whether it will be safe. Unfortunately, like nearly everything about flu bugs, safety can’t be guaranteed 100%.

What’s reassuring is that there’s been no safety issue with previous H1N1 flu vaccines. We take them every year. There are rare adverse events, but the benefit of vaccination far outweighs this small risk.

Safety tests will be performed on the new vaccines. But there won’t be a lot of time to see what happens in the long term. If the vaccines seem relatively safe — that is, if they don’t seem harmful in the first weeks after they’re administered — they’ll be rolled out on a massive scale. That means relatively rare side effects will be seen only after millions of people are vaccinated.

The last time the nation faced something called swine flu was in 1976. That’s when a flu of swine origin struck an army base, triggering fears of a pandemic. A vaccine was rushed into production. Manufacturers demanded that the government indemnify them against possible injury claims, making the public wary before vaccination even began.

It’s still not clear why a rare but serious neurological disorder called Guillain-Barre syndrome hit those vaccinated in 1976 at a higher-than-expected rate. But after some 44 million Americans received the vaccine, safety fears scuttled the vaccination program — and gave “swine flu vaccine” a bad name that still lingers in the American psyche.

How the public perceives the safety of the vaccine will depend on how severe the flu pandemic turns out to be, flu expert Andrew Pavia, MD, said at a June meeting at the Institute of Medicine.

“If this were a 1918-like pandemic, we could tolerate a fair degree of risk,” Pavia said. “But for this virus, our sensitivity to risk is going to be much more difficult to calibrate.”

September

One Dose or Two?

By mid-September, results from clinical studies will show the best dose for pandemic swine flu vaccine, how many doses are needed for which populations, and whether the vaccine appears safe in different populations.

If the decision was made in August to start packaging vaccine doses, vaccine will become available around Sept. 15. Early results from clinical trials will guide the decision whether to start vaccinating people. But that decision will have to be made before officials have all the information they’d like to have.

A huge question is whether it will take two doses of vaccine to immunize against pandemic flu. It’s possible that because this is a new flu, everyone will be like a small child. Children who’ve never had a flu shot need two flu vaccinations, weeks apart, to be immunized.

But it might take only one shot. Or maybe some people could get by with one shot — perhaps those who have had repeated seasonal flu shots, those who have been infected with seasonal H1N1 flu, or those born before 1957 when a different H1N1 flu circulated.

Who Will Want the Swine Flu Vaccine?

A decision will be made whether to deploy pandemic swine flu vaccine for some or all U.S. residents. If that happens, the CDC will begin an intensive campaign to persuade people at high risk of flu complications to get vaccinated. The program will have to address issues of vaccine safety in a straightforward manner. “Public trust is crucial; we risk it at our peril. If we risk public trust with bad vaccination decisions, it will take us years to recover,” Pavia warns.

“You are going to have less data than you want to make a decision on the go or no-go, but you are going to have to make it on the best available data at the time,” says Gellin. “The middle of September is where all this stuff theoretically converges. That is the point where at least we think we will have preliminary data to see how the vaccine is performing and say where are we with this epidemic and what is the situation.

• Swine Flu Center
• Video: Swine Flu Precautions
• Swine Flu Symptoms
• What Is a Pandemic?
• CDC Swine Flu Updates
• State-by-State Information
• World Health Organization

What People Are Asking

• Our experts answer your swine flu questions.
• Talk with others about swine flu.

Swine Flu Slideshow

Like people, pigs can get influenza (flu), but swine flu viruses aren’t the same as human flu viruses. View the slideshow.

© 2009 WebMD, LLC. All rights reserved.

October Through December

If a vaccine has not already been rushed into use, officials will make final preparations for vaccination programs in early October. This will include a priority list of who gets the vaccine first.

By late November, the first clinical studies of pandemic swine flu vaccine will be completed. If results differ from preliminary findings, vaccination programs will be adjusted.

Early December

Even if unexpected events delay a vaccination program, most experts think vaccine will be ready by the end of December. That means huge numbers of Americans will be offered the vaccine before flu season hits its usual peak in January or February. Even if there’s already been a second pandemic wave, this will blunt new waves of pandemic illness.

But will Americans accept a vaccine that arrives after the pandemic peaked? Will safety concerns wreck the expensive program? Even the best laid plans often go awry.

4 Must-See Articles

• Who’s at High Risk From Swine Flu?
• Most Americans Expect Serious Outbreak of Swine Flu
• Swine Flu Vaccine Fast Track
• Will Swine Flu Symptoms Keep You at Home?

View Article Sources

SOURCES:

Presentations to the American Committee on Immunization Practices, Atlanta, June 24-26, 2009.

Presentations to the Institute of Medicine Forum on Microbial Threats, June 16, 2009.

Tony Fauci, MD, director, National Institute of Allergy and Infectious Diseases.

Kathleen M. Neuzil, MD, MPH, University of Washington; and chairwoman, ACIP Influenza Workgroup.

Nancy J. Cox, PhD, director, Influenza Division, CDC, Atlanta.

Robin Robinson, PhD, director, Biomedical Advanced Research & Development Authority and assistant secretary for preparedness & response, HHS, Washington, D.C.

Bruce Gellin, MD, MPH, director, National Vaccine Program Office and deputy assistant secretary of health, HHS, Washington, D.C.

John Treanor, MD, professor of medicine, and of microbiology and immunology, University of Rochester, New York.

Andrew Pavia, MD, chief of pediatric infectious diseases, University of Utah, Salt Lake City.

© 2009 WebMD, LLC. All rights reserved.

H1N1 flu vaccine ready in October, Sebelius says

Posted: 12:15 PM ET

WASHINGTON (CNN) — An H1N1 flu vaccine should be ready in October if a strain now moving through the southern hemisphere heads north for the fall and winter, Health and Human Services Secretary Kathleen Sebelius said Sunday.

Speaking on NBC’s “Meet the Press,” Sebelius said the vaccine still must undergo clinical trials to ensure it is both effective against the virus and safe for people.

“We’re on track to have a vaccine ready by mid-October,” she said.
The pandemic was first detected in Mexico earlier this year before moving to the United States, Europe and other nations in the northern hemisphere. The virus is now more prevalent in the southern hemisphere, where is it is winter.

Flu is typically more active and prevalent during the fall and winter.

The World Health Organization raised the worldwide pandemic alert level June 11 to phase 6, the highest designation. The most recent WHO figures, from early July, listed 170 flu fatalities in the United States, along with 119 in Mexico and 60 in Argentina.

However, the figures have risen since then. WHO stopped listing national totals after July 6 because, the organization said, “the increasing number of cases in many countries with sustained community transmission is making it extremely difficult, if not impossible, for countries to try and confirm them through laboratory testing.”

First Trials of Swine Flu Vaccine Begin in Australia (Update1)

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By Simeon Bennett

July 22 (Bloomberg) — Nurse Luiza Duszynski flicks her syringe, squeezes a few drops of clear liquid from the needle and pushes it into Tara Seaton’s arm. With that, she became one of the world’s first recipients of a vaccine for swine flu.

Seaton is among the 240 healthy adult volunteers in Australia who CSL Ltd. began injecting today with its experimental vaccine against H1N1, the new virus strain that sparked the first influenza pandemic in 41 years.

“It was fine, I didn’t even feel it,” Seaton, a 28-year- old post-office assistant, said from the Royal Adelaide Hospital, where she received the shot.

CSL is testing the vaccine over the next seven weeks as it prepares to fill orders from Australia, the U.S. and Singapore. The World Health Organization and Melbourne-based CSL’s larger rivals such as Sanofi-Aventis SA will be watching the test to help determine whether one or two shots are needed to protect people and how many doses can be produced.

“The fundamental data that we and others around the world are interested in are the immune response to the first and second dose,” Andrew Cuthbertson, CSL’s chief scientific officer, told reporters in Adelaide. The test results will also show the effects of different doses, he said.

Volunteers are required to keep a diary for six months and record any signs and symptoms, including nausea, increased temperature and swelling around the injection area, Seaton said.

Swine flu has killed more than 700 people globally and sickened so many the WHO has stopped issuing a daily tally.

Other Makers

Novartis AG expects to start trials of its shot this month, Eric Althoff, a spokesman for the Basel, Switzerland-based drugmaker, said today, without giving a date. Sanofi plans to start tests of its shot in August, Albert Garcia, a spokesman for the Paris-based company’s vaccines unit, said in a phone interview.

“It is reasonable to say that, if all goes well, we will start delivering the vaccine by November or December,” Garcia said late yesterday. “This is the most reasonable time frame.”

David Outhwaite, a spokesman for GlaxoSmithKline Plc, declined to answer questions about the London-based drugmaker’s plans to test its shot. Deerfield, Illinois-based Baxter International Inc. will produce a vaccine by early August, after which it will perform clinical tests, spokesman Chris Bona said.

CDC Forecast

The Atlanta-based U.S. Centers for Disease Control and Prevention has said it expects a vaccine ready for widespread distribution in October.

Vaxine Pty, a South Australian biotechnology company, said it started tests on 300 volunteers in Adelaide on July 22 using a vaccine that’s boosted with a novel sugar-based compound. The company, based in Adelaide’s Flinders Medical Centre, has no orders yet for its experimental shot, Research Director Nikolai Petrovsky said in a telephone interview today.

There isn’t any commercial advantage to being the first maker to start human trials, as most manufacturers already have orders to supply vaccines to governments, said David Low, a health-care analyst at Deutsche Bank AG in Sydney.

“Being first is probably more of a PR coup,” Low said in a telephone interview on July 16.

CSL may record sales of A$300 million ($244 million) this year for its swine-flu vaccine, said Alexander Smith, a health- care analyst at JPMorgan Chase & Co. in Sydney.

“That sounds reasonable,” said Rachel David, a CSL spokeswoman.

Two Shots

Two shots of vaccine will probably be needed to protect people against the pandemic virus, said Michael Osterholm, director of the Center for Infectious Disease Research and Policy, at the University of Minnesota in Minneapolis.

CSL has a contract to supply 21 million doses to the Australian government and an order from the U.S. for $180 million of antigen, enough for 20 million to 40 million doses, David said. The company also has an order from Singapore, she said, declining to give details.

The company is producing the CSL425 vaccine at capacity with the current customer base, David said.

The vaccine maker will give volunteers aged 18 to 64 years two shots, three weeks apart, to determine how many doses are needed to get the right level of protection, David said.

CSL is also testing the pandemic vaccine, known as Panvax (H1N1 A/California) in Australia, in a regular and double dose to see which is more effective, she said.

Volunteer Seaton said she had no fears about the injection and any possible side effects. The A$400 she received for participating in the trial was a bonus.

“I thought, worst-case scenario, if everyone gets swine flu then I’ll be vaccinated against it,” she said.

To contact the reporter on this story: Simeon Bennett in Singapore at sbennett9@bloomberg.net

Last Updated: July 22, 2009 06:38 EDT

From Reuters Health Information

Mystery Solved? Immunoglobulin D Improves Immune Surveillance in Respiratory Tract

NEW YORK (Reuters Health) Jun 29 - Although discovered more than 40 years ago, the role of immunoglobulin D has been unclear. Now, new research suggests that the antibody class works with various immune cells to fight infections in the upper respiratory tract.

As reported in the June 28th online issue of Nature Immunology, Dr. Andrea Cerutti, from Weill Cornell Medical College, New York, and colleagues found that B cells in the tonsils and upper airway tissues produce immunoglobulin D.

After release, immunoglobulin D binds to bacteria and other pathogens. The IgD-bound microbes then stimulate various antimicrobial, proinflammatory, and B cell-stimulating programs in basophils.

“Human B cells may produce IgD to ‘instruct’ basophils as to the antigenic composition of the upper respiratory tract,” the authors propose. “This evolutionarily conserved immune surveillance system would not only monitor systemic invasion by airborne pathogens but also regulate B cell homeostasis, antibody production, and inflammation.”

Nature Immunol 2009.

IDF Needs Your HELP to Fix IVIG Access and Reimbursement
Contact Your Senators and Representative!

After the 4th of July recess, Senate and House Committees will begin to consider the much talked about health care reform legislation, including changes to the Medicare program. And both the House of Representatives and the United States Senate will continue to debate health care reform during the month of July. It is imperative that the language in HR 2002 and S. 701, the Medicare Patient IVIG Access Act be included in any health care reform legislation passed by this Congress. Your voice at this critical time is important for both chambers of Congress to hear!!

The members of the Senate and the House need to know that people care about IVIG and they need to have IVIG access problems addressed in the health care reform bills.

Please act now and ask your families and friends to contact their Senators and Representative by participating in IDF’s Action Alert. You make the difference!

Contact Your Representative

In 2005, Congress changed the way Medicare pays for IVIG and, as a result, many doctors no longer provide the treatment - making it harder for patients to get IVIG.  Also, current law does not pay for the nursing and IV items needed for IVIG therapy administered in the home. These serious problems affect the entire community as an increasing number of private pay insurers are following Medicare’s lead.

To fix this problem, Representatives Israel (NY), Brady (TX) and, Schwartz (PA) introduced HR 2002, the Medicare Patient IVIG Access Act, and Representatives Matsui (CA) and Tanner (TN) introduced HR 1765. Both of these bills are critical to patients who rely on IVIG therapy for their health, as they correct the current problems and respond to government reports that confirmed these problems.

Please contact your Representative’s office and urge them to include HR 2002 and HR 1765 in any health care reform legislation passed by this Congress. Call the US Capitol Switchboard at (202) 224-3121 and request to be transferred to your Representative’s office. Please also CLICK HERE TO SEND THE ACTION ALERT LETTER to your Representative!

Contact Your Senators

In 2005, Congress changed the way Medicare pays for IVIG and, as a result, many doctors no longer provide the treatment - making it harder for patients to get IVIG.  Also, current law does not pay for the nursing and IV items needed for IVIG therapy administered in the home. These serious problems affect the entire community as an increasing number of private pay insurers are following Medicare’s lead.

To fix this problem, Senators Kerry (MA), Alexander (TN), Wyden (OR), Whitehouse (RI) and Brownback (KS) introduced the Medicare Patient IVIG Access Act, S 701.

Please contact both of your Senators, and urge them to include S. 701 in any health care reform legislation passed by this Congress. Call the US Capitol Switchboard at (202) 224-3121 and request to be transferred to your Senator’s office. Please also CLICK HERE TO SEND THE ACTION ALERT LETTER to both of your Senators!

IDF Action Alert - Contact Your Representative!

IDF needs your HELP to Fix IVIG Access and Reimbursement

Take Action!

Contact Your Representative!

Both the House of Representatives and the United States Senate are currently debating and will continue to debate, during the month of July, health care reform legislation.  It is imperative that the language in HR 2002 and S. 701, the Medicare Patient IVIG Access Act be included in any health care reform legislation passed by this Congress.  Your voice at this critical time is important for both chambers of Congress to hear!!

In 2005, Congress changed the way Medicare pays for IVIG and, as a result, many doctors no longer provide the treatment - making it harder for patients to get IVIG.  Also, current law does not pay for the nursing and IV items needed for IVIG therapy administered in the home. These serious problems affect the entire community as an increasing number of private pay insurers are following Medicare’s lead.

To fix this problem, Representatives Israel (NY), Brady (TX) and, Schwartz (PA) introduced HR 2002, the Medicare Patient IVIG Access Act, and Representatives Matsui (CA) and Tanner (TN) introduced by HR 1765. Both of these bills are critical to patients who rely on IVIG therapy for their health, as they correct the current problems and respond to government reports that confirmed these problems.

Please contact your Representative’s office and urge them to include HR 2002 and HR 1765 in any health care reform legislation passed by this Congress.  Call the US Capitol Switchboard at (202) 224-3121 and request to be transferred to your Representative’s office.  Please also send a letter!