http://media.netpr.pl/notatka_78765.html
Orencia(R), (abatacept), a next generation treatment for moderate to severe rheumatoid arthritis has been launched in the UK by Bristol-Myers Squibb Pharmaceuticals Limited (BMS). Orencia has a unique mode of action offering long-term efficacy for patients with rheumatoid arthritis (RA) who have failed on anti-tumor necrosis factor (TNF) therapy.(1,2)
Pip - I am always very polite, until someone *$##@# me off :) Cathy
PS I liked reading this article because it actually admits that RA is unpredictable in each different patient. So why do they (whomever they are) insist that we have to fit a certain, poorly designed diagnostic "box" in order to be believed? Is this just insurance companies who are calling the shots now, literally?Well in the case of this article it is the National Health Service of Great Britain who decides who is elgible. Say what you will about American Insurance companies but it is far easier to be prescribed a biologic here than in any country with socialized medicine. Most insurance policies cover these meds to some extent. Socialized medicine will pay but you have to be the worst of the worst and jump through hoops to be elgible.
So which is worse access with some financal difficulties or limited access with govt paying. Both systems need fixing.
In the states diagnostic criterea is set by the disciplines governing board so rheumatological diseases critera are set by the Am College of Rheumatologist. Treatment believe it or not is also set by the doctors. In reality, the only thing an insurance company (or your employer since they buy the policy) controls is who is going to pay.
Cathy, have you ever read the book "How Doctor's Think". If not you should. Its fascinating reading. Knowing the thought processes might help you tweak your approach to the medical community so that they are working with you
Buckeye, that sounds like a good book, but I found two by that title...one released this year by Jerome Groopman, and the other released in 2005 by Kathryn Montgomery. Which did you recommend?Buckeye it's not necessarily so that its hard to get biologics in a country with socialized medicine. You don't have to jump through hoops to get the medications that you need. I know several people have been prescribed biologics that aren't in the worst of the worst category. There is NOT limited access to necessary meds in Australia. As always the lighter options (methotrexate, plaquenil, arava) are given first but when they are not working there is no delay by doctors (or government) in adding biologics.
Pammy
I know they are available but the Natl Health Service's have determined the criterea for receiving these meds. I know at one point the Australian critera included needing to be sero positive only. If you were sero negative irregardless of your symptoms you were turned down. I'm pretty sure that has changed now, but why was it ever a requirement if you can have the diesase being sero negative.
I guess my point was is there are "boxes" in every medical system. Some are put there by the physicians, some by the insurance companies and some by the governments. BUt irregardless they are there
LOL - but let's not confuse politeness with manners!
Seriously, that's a PR newswire piece, basically a puff piece by Bristol Meyers. Which I'm OK with. And it's great that there's another drug in the arsenal for people that choose it. What bothers me is the company missions. They said explicitly in the newswire (twice):
Orencia is the latest example of Bristol-Myers Squibb's delivering on our commitment to bring innovative medicines to patients with unmet medical needs and to living our mission to extend and enhance human life."
It is NOT their mission to erradicate disease. Not one of the Big Pharma companies has eradicting the disease as part of the 'big picture' mission.
That's what disturbs me.
Pip
PS. Are you on some sort of RSS feed to always see this stuff so soon? Can you teach me how to do that?
Pip
I wasn't aware that people had a hard time getting biologics in Canada. I meet a lot of arthritics at arthritis school and that has never come up, so I think it's a non-issue around these parts. In fact, from reading these boards I'm getting the sense that Canadians are having an easier time getting the treatments they need, except for some longer waits for certain surgical procedures.Gimpy, I have a close friend in Victoria who isn't receiving treatment for her RA/OA except for pallative. She's also on a waiting list that's about 18 months out for a knee replacement. This same knee has had 5 prior knee surgeries. She's on large doses of pain killers and they still refuse to move her towards the top of the surgical list. Her only means of ambulation is a motorized scooter. She can't walk due to the pain. She's on a medication for another medical problem which isn't even prescribed in the U.S. any longer because the medication has been replaced by a med that is better overall. My cousin in Surrey also is awaiting surgery and has been waiting for nearly a year. The only thing that's done is to give her more pain pills.
Our friends who live on one of the islands in upper B.C. come to the United States for treatment because she has Hepatitis C and had to wait for months to get an MRI and additional treatment.
A friend from Sook also comes to the U.S. for common treatment for a heart condition that isn't available in the Canada.
These are just 4 examples of dissatisfied users of the Canadian medical system. I'm sure there are many thousands that are happy to wait, because they know no better.
I have many Canadian friends and family and from what I gather it's not the best healthcare system in existence. Our healthcare system is flawed but we get treatment within a reasonable length of time. Our health both physically and mentally isn't jeopardized due to a year's wait for necessary treatment. We do get treatment in a timely manner and we do get current, updated medications to treat our illnesses. I'll deal with any insurance issues and work the system so I can have my knee replacements next month. Exactly 2 months after recommendation.
Apparently, the system works for you, and I think that's wonderful for you, but don't tell my friends and family that the system works, because they'll beg to differ with you.
I'm not going to debate the virtue of one system over the other but I did want to bring it to the attention of the forum that not all Canadians are enthralled with their healthcare system. I'm sure there are reports and statistics that can be downloaded to the forum to show that the system works well and everyone is happy but I don't think the people that I wrote about, know, and love are happy with the Canadian healthcare system.
Hey..this really wasn't supposed to be an arguement about medical systems. There are good and bad about all systems. I was trying to say that biologics are generally prescibed earlier in the disease process in the U.S. in part because dr's really don't care who pays and in part because the anti-tnf's are approved for moderate disease as well as severe. Insurance companies may have guidelines that need to be followed before they pay but the medications will still be prescribed if the dr feels necessary. Most countries with socialized medicine have strict guidelines, limiting them in most cases considered severe, that must be meet before biologics will be considered. In Great Britain only about 1/2 the people doctors consider medically elgible, have been approved by the NHS to receive this med. Of course everyone's experience may differ.
The Canadian system works great for some people. It doesn't work great for others. The American system works great for some people and it doesn't work well for others. Neither system is perfect
Buckeye, thanks for clarifying. I don't wish to debate this but was just pointing out that there are others in Canada who find the system lacking. I admitted that ours is a flawed system as well, but flawed in a different way. The issue being there are 2 sides to the story, and I wanted to make sure that the other side was heard about. Gimp, I'd never state that your personal experiences aren't accurate; the system works for you.
It's interesting to hear about healthcare in other countries and how well it works or doesn't work. When our politicians look and analyze what works in other countries and what doesn't work then maybe we'll have a healthcare system that has the best of all the countries healthcare modalities. We could only hope.
Where the Canadian system works really well is no-pay access for all. Where we fall down is waiting times for some tests and treatments. (We also have a problem with losing docs to the US who want more pay.)Gimpy, LinB, and Joy
The website below, takes a look at coverage of biologics province by province. BC's pharmacare program has the toughest requirements.
http://www.arthritisconsumerexperts.org/pdfs/Pharmacare-biol ogic-coverage-overview.pdf
For any Canadians who are posting or lurking... I love that word!
Arthritis Consumer Experts (ACE) publishes free monthly newsletters called the Joint Health monthly. Check out the most recent newsletter on ACE's website. There are also podcasts about the newest meds and med trials, interviews with Canada's leading rheumatologist and researchers.
www.arthritisconsumerexperts.org
The neat thing is ACE doesn't promote any brands or programs. Its mandate is "to provide free researched-based education and information to Canadians living with arthritis."
Every month the newsletter has been spotlighting a type of arthritis,and talks about how it's diagnosed and the treatment options that are available... March was ankylosing spondylitis, and April was lupus (SLE)... the April issue gave tips on getting referred to a rheumatologist. It's a great newletter. I hope you'll check it out.
I never had any problem being approved for Enbrel. I started taking it almost as soon as it came on the market. I was approved in less than two days.
Thanks Cathy!
Do you think with the RSS being bought out it will not be a good source of current info anymore?
Pip
Pip - good question. I know the inventor of RSS must be pretty happy :) If the new company (is it google or yahoo maybe?) keeps it simple and keeps it working, it will be great. When they come in and start putting all these extra bells and whistles on perfectly good easy formatting, that's when I give up on using a service. And the google news alert system is on the left side menu now, it was on the bottom last time I used it :) Cathy PS If I had known you could get a job as "researcher", that's what I would have wanted to be when I grew up LOL I like to read the dictionary and encyclopedias, and research, too bad this career wasn't mentioned during high school career days 36 years ago.Well, when I get more organized (I know: it's my mantra) I'm going to pm you and get more advice. I really want to get into the current newbreaking info. Have you looked at, what is it, Ben's stem cell cure, or whatever that site is. He organizes everything about stem cells but lists a lot of RA stuff. That's what we need; somebody who can do that for us.
Pip
Thanks for the info Punkie ... I signed up for the newsletter! Sorry, I am not trying to stir the pot so to speak...but watching people debate about which insurance is worst makes me ill...good gawd be happy you have ANY coverage. Many out here have no coverage and cannot get any at any price because of the RA.