Memorial Sloan-Kettering Will Not Offer Zaltrap | Fight Colorectal ...

Memorial Sloan-Kettering Cancer Center?made a very public announcement?and explanation?today in a New York Times op-ed about why they will not offer the new drug Zaltrap? (ziv-aflibercept) to its metastatic colorectal cancer patients.

The authors, all world-renowned cancer specialists at the world?s oldest cancer center, in an?op-ed headlined ?In Cancer Care, Cost Matters,??essentially challenged other cancer centers to take action where politicians fear to tread.

?We recently made a decision that should have been a no-brainer,? wrote Drs. Peter B. Bach, Leonard B. Saltz and Robert E. Wittes. ?The drug, Zaltrap, has proved to be no better than a similar medicine we already have for advanced colorectal cancer, while its price?at $11,063 on average for a month of treatment?is more than twice as high.?The FDA approved Zaltrap in August for use in metastatic colorectal cancer (mCRC). Both Zaltrap (marketed by Sanofi and Regeneron) and Avastin? (bevacizumab, marketed by Genentech) work through a similar molecular mechanism, and when either medicine is added to standard chemotherapy, ?either medicine has been shown to prolong patient lives by a median of 1.4 months.?

(Note: the authors disclosed that two of them?Drs. Bach and Saltz?have received consulting fees by Genentech.)

?In most other industries, something that offers no advantage?yet sells for twice the price would never even get on the market,? they wrote. But health care is not like other industries. Medicare, as well as private insurers in most states, are required to cover a new drug once it receives FDA approval. But the FDA can only consider whether a new drug is ?safe and effective??not more effective, and costs cannot be considered by either the FDA or Medicare.

The Memorial Sloan-Kettering Cancer Center leaders noted that their seemingly rational decision to use the less expensive, equally effective drug would likely be called ?rationing, not rational? in a culture where no politicians seem willing to address rising costs of cancer.

?But if no one else will act, leading cancer centers and other research hospitals should,? they challenged their peers. ?The future of our health care system, and of cancer care, depends on our using our limited resources wisely.?

Colorectal cancer is typically diagnosed in older people covered by Medicare, which requires a 20 percent copayment for drugs. An older person without supplemental Medicare insurance would have to pay more than $2,200/month for Zaltrap?which is more than the total monthly income for half of Medicare participants. Avastin would cost about $1000 a month.

The medical world already buzzing

Respected health economist Vivian Ho, the James A. Baker III Institute Chair in Health Economics at Baylor College of Medicine and economics professor at Rice University quickly weighed in with her approval.

The Oct. 15^th issue of ClinicalOncology News (an online newsletter for physicians),?published a related report about how researchers and doctors? discussions about both benefits and costs of new drugs can confuse patients, community oncologists, and yes, politicians.

The pharma blogworld is providing lively coverage and comments: Read more at? PharmaLot blog site?and? the pharma news service Fierce Pharma.

You?ll likely see other mass media covering this decision by Memorial Sloan-Kettering Cancer Center, such as this Washington Post blog.

What this means for patients:

In the current American medical system and political climate, it?s up to the individual patient and oncologist to seriously discuss the real costs and benefits especially about new drugs becoming available for metastatic CRC.

Stay tuned: Fight Colorectal Cancer will continue monitoring the medical and political worlds, as well as agencies such as Medicare and insurers making coverage decisions.

?Source: Oct. 14 online edition of New York Times, and then in print on Oct. 15, p. A25 of the New York edition.

Disclosure: Fight Colorectal Cancer has accepted funding for projects and educational programs from sanofi-aventis and Genentech in the form of unrestricted educational grants. Fight Colorectal Cancer has ultimate authority over website content. See the Fight Colorectal Cancer Funding Policy and Disclosure.

Source: http://fightcolorectalcancer.org/research_news/2012/10/memorial_sloan-kettering_will_not_offer_zaltrap

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Video: Stocks Priced for Perfection?

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Source: http://video.msnbc.msn.com/cnbc/49419088/

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Pizza Hut rethinks presidential debate stunt

In this combination of file photos, Republican presidential candidate former Mass. Gov. Mitt Romney, left, takes a bite of pizza during lunch with his wife Ann while campaigning at Village Pizza in Newport, N.H., Dec. 20, 2011, and then-Senator Barack Obama, right, takes a bite of pizza at American Dream Pizza in Corvallis, Ore., March 21, 2008. Pizza Hut is offering a lifetime of free pizza, one large pie a week for 30 years, or a check for $15,600 to anyone who poses the question "Sausage or pepperoni?" to either President Barack Obama or Republican candidate Mitt Romney during the live Town Hall-style debate next Tuesday, Oct. 16, 2012. (AP Photo)

In this combination of file photos, Republican presidential candidate former Mass. Gov. Mitt Romney, left, takes a bite of pizza during lunch with his wife Ann while campaigning at Village Pizza in Newport, N.H., Dec. 20, 2011, and then-Senator Barack Obama, right, takes a bite of pizza at American Dream Pizza in Corvallis, Ore., March 21, 2008. Pizza Hut is offering a lifetime of free pizza, one large pie a week for 30 years, or a check for $15,600 to anyone who poses the question "Sausage or pepperoni?" to either President Barack Obama or Republican candidate Mitt Romney during the live Town Hall-style debate next Tuesday, Oct. 16, 2012. (AP Photo)

NEW YORK (AP) ? Pizza Hut is rethinking its contest daring people to ask "Sausage or Pepperoni?" at the presidential debate Tuesday.

After the stunt triggered backlash last week, the company says it's moving the promotion online, where a contestant will be randomly selected to win free pizza for life.

The pizza delivery chain had offered the prize ? a pie a week for 30 years or a check for $15,600 ? to anyone who posed the question to either President Barack Obama or Republican candidate Mitt Romney during the live Town Hall-style debate.

But blogs and media outlets immediately took the pizza delivery chain to task for trying to capitalize on the election buzz by injecting itself into the process.

Pizza Hut spokesman Doug Terfehr said the majority of the feedback the company has seen has been very positive. He said that moving the contest online was a "natural progression of the campaign" after people got excited about the idea and "wished they could get in on it."

Pizza Hut, a unit of Yum Brands Inc., says it will still honor the prize if someone poses the question live at the debate. But it's encouraging everyone to participate in the new online version, where contestants must enter their email addresses and zip codes to be eligible. The company will award two prizes if someone does ask the question.

The change comes after Pizza Hut's stunt became the butt of jokes last week.

In a segment on Comedy Central's "Colbert Report," host Stephen Colbert asked, "What could be more American than using our electoral process for product placement?"

Colbert said the prize for a free Pizza Hut pie every week meant that "if you eat one of their pizzas every week, you will die in 30 years."

The blog Gawker wrote about the stunt under the headline, "Want Free Pizza Hut Pizza for Life? Just Make a Mockery of the American Democratic System on Live TV." The site wrote that all the contestant had to do was "embarrass themselves on live television before the President of the United States and millions of their fellow Americans."

Pizza Hut's stunt comes as TV audiences have become increasingly resistant to traditional commercials. As marketers look for new ways to engage viewers, the presidential election has presented a rare opportunity.

Earlier this month, an estimated 67.2 million people watched the first debate between Obama and Romney. That made it the largest TV audience for a presidential debate since 1992, according to Nielsen's ratings service.

This isn't the first time a promotion tied to current events has backfired. Last year, Kenneth Cole compared the Arab Spring uprisings to a frenzy over the U.S. designer's spring collection; the company later apologized.

___

Follow Candice Choi at www.twitter.com/candicechoi

Associated Press

Source: http://hosted2.ap.org/APDEFAULT/3d281c11a96b4ad082fe88aa0db04305/Article_2012-10-15-Pizza%20Hut-Election/id-a4151ee1dace4598a0c43457c6c1001f

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Dem, GOP insiders expect better debate performance from Obama

There is bipartisan agreement on at least one thing as the second presidential debate looms: President Obama will turn in a better performance on this occasion than he did last time around.

Obama?s weak and disengaged display at the first debate on Oct. 3 allowed Republican challenger Mitt Romney to reshape a race that had seemed to be slipping from his grasp.

Romney has risen rapidly in the polls since then. He now holds a lead in many nationwide surveys, while Obama clings to a shrinking advantage in several battleground states.

But Washington insiders of all ideological stripes concur that Obama is too competitive a man and too gifted a politician to slip up so dramatically for a second time, when the candidates go under the spotlight at Hofstra University in Hempstead, N.Y., on Tuesday.

Underlining the stakes involved, Obama has been in near-seclusion in Williamsburg, Va., since Saturday afternoon. He will not leave until the day of the debate.?

Obama took a break to deliver pizza to campaign volunteers on Sunday, and told reporters his preparations were ?going great.? Even such an innocuous comment marked a tonal contrast from the lead-up to Denver.?

Making a similar visit back then, Obama had only semi-jokingly complained that prep was ?a drag. They?re making me do my homework.?

The president is accompanied in Williamsburg by the same team that readied him for the first encounter, including senior advisor David Axelrod, former communications director Anita Dunn and Sen. John Kerry (D-Mass.), who has been playing the role of Romney.

Obama has already studied video of the ignominious first debate.

?He knows he wants to have a stronger performance,? one aide told The Hill.

An Obama campaign spokeswoman, Jen Psaki, said that the president was ?fired up, energized and excited.?

A Romney aide offered a more sardonic commentary on Obama?s likely performance.

?He?ll probably have a cup of coffee this time,? the source said, going on to poke fun at the explanation for the president?s desultory showing offered by former Vice President Al Gore: that he might have been affected by Denver?s high altitude.

?The altitude won?t be as bad? on Tuesday, the Team Romney member said. ?The elevation is less than 70 feet above sea level, so the president won?t have that as an excuse.?

But some Republicans fear that Obama?s first performance might actually help him this week, at least so far as expectations are concerned.

?The bar for Obama is low,? said Texas-based GOP consultant Mark McKinnon. ?All he has to do is show up awake this time and it will be scored a victory compared to last time.?

Democrats, meanwhile, take heart from the fact that Obama has long displayed a capacity to perform at his best when the pressure is at its most intense.

This pattern has been noticeable in both campaigns and governing, they say.

In 2008, when the incendiary sermons of Rev. Jeremiah Wright threatened to engulf his candidacy, Obama responded with a speech on race that was among his finest moments.

In the White House, he piloted his healthcare law through Congress after some of his advisors had given up hope of widespread reform and urged him to settle for more modest goals.

?He is a fourth-quarter player; he?s really good when the pressure is on,? said Democratic consultant Bob Shrum, who has worked on numerous presidential campaigns.

?I anticipate Obama being as good as he has ever been,? Republican strategist Trey Hardin agreed. ?I anticipate him bringing his A+ game. I would expect [to see] an individual who is a better communicator, who can be likable ? and who is going to prepare in every waking moment between now and then.?

Observers on both sides of the partisan divide are still coming to terms with the turbulence of the past few weeks.

First, a covertly-filmed video emerged of Romney?s ?47 percent" remarks; then Obama crashed and burned at the debate; and, most recently, Vice President Biden soothed frazzled Democratic nerves with his combative performance in his debate against Romney?s running mate, Rep. Paul Ryan (R-Wis.), last week.

There was no clear victor in the Biden-Ryan tussle, but Democratic strategists like Doug Thornell argued that the vice president?s vigor in defense of the administration was important in itself.

?He calmed some of these Democrats who were thinking of jumping off the bridge and now they are going to step back from the ledge,? Thornell argued. ?They saw a guy there fighting his butt off. That meant a lot to the people who are part of the Obama campaign, from Chicago [headquarters] to the people on the ground in states like Iowa. Emotionally, psychologically, that is a big lift.?

Even if Biden restored liberal spirits, however, his gains could all be undone if Obama does not to come to the stage in Hempstead in finer fettle than he did in Denver.

Obama needs ?to drop the cool, detached, professorial demeanor and go right at Romney on all the issues, including his comments on the 47 percent and the $5 trillion tax cuts,? said Jim Manley, the former head of Senate Majority Leader Harry Reid?s (D-Nev.) communications operation, who now works for lobbying firm Quinn Gillespie.

?He?s got to be willing to draw the contrasts and be aggressive, and also be presidential,? Shrum concurred. ?The ideal is being authoritative and engaged.?

Tuesday?s debate is the only one that will be in a town hall format, with the questions being posed by voters in attendance and the moderator ? CNN?s Candy Crowley ? confining herself mostly to the role of a facilitator.

The format brings its own challenges and opportunities for both Romney and Obama.

Republican strategist Ken Lundberg fretted that the setting could, from his side?s perspective, be a problem. Obama ?thrives in that environment and Romney needs to realize that,? Lundberg said.

On the brighter side, from the GOP?s perspective, ?we have seen that there are two Obamas: one in front of the teleprompter and one not in front of the teleprompter,? Hardin said. ?At a town hall debate, you don?t even have notes, which you do at a podium. I think Romney is going to be prepared to throw so much at Obama.?

Republicans believe that another victory for Romney could see a decisive erosion of Obama?s support.

For Democrats, meanwhile, a good performance from the president would not just right the ship; it would also be a welcome balm after the debacle in Denver.

?The president is a big-game player,? Doug Thornell said. ?I fully expect him to do well ? and erase what happened.?

---

Source: http://thehill.com/homenews/campaign/261875-experts-concur-expect-a-better-performance-from-obama-this-time

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Final Numbers Are In: Space Jump Breaks YouTube Record

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Hostpital at center of meningitis scare battles to save lives

NASHVILLE, Tennessee (Reuters) - At the epicenter of one of the worst U.S. health scares in recent history, staff at St. Thomas Hospital have battled around the clock for more than two weeks to the save the lives of patients stricken with meningitis.

The sprawling complex better known as a hospital for heart patients, which sits atop a hill overlooking a wealthy area of Nashville, has treated more than 15 percent of all victims in the nation of a rare form of fungal meningitis.

St. Thomas is the place where doctors first began to realize something was horribly wrong with back pain medications shipped from New England Compounding Center in Massachusetts.

Fifteen people have died of meningitis in six states since the outbreak began. Some 203 people have been sickened with meningitis in 14 states and the numbers continue to mount.

The illness is believed to be linked to fungus contamination in some of the steroid shipped from NECC used mostly for epidural injections to control back pain.

Since the beginning of the month, some 330 patient have gone to the St. Thomas 29-bed emergency room, where the triage area is named after the mother of comedian, actress and star of "Laugh In" Lily Tomlin, whose family is from Nashville and donated privately to the facility.

But it is no laughing matter of late, as two people have died of meningitis at St. Thomas and the hospital has treated 33 of the 53 cases of meningitis in Tennessee, the hardest hit state.

While the hospital has not given patient names, one of the casualties at St. Thomas was Reba Temple, 80, of Centerville, Tennessee, according to a family friend. Temple herself was a former health director of Hickman County.

More than 275 patients have undergone spinal tap tests at the hospital, a painful procedure to determine if they have meningitis.

"That has to be some type of entry for the Guinness Book of World Records, an entry I wish we could have avoided," Dr. Robert Latham, chief of medicine and director of the Infectious Diseases Program at the hospital, said on Friday.

At one point 40 to 45 patients who had received injections were being treated at St. Thomas each day, officials said.

Of those who have survived so far, two remain in critical condition, 28 are in stable condition and on Friday the hospital sent the first of its victims home, where the patient will continue intravenous anti-fungal therapy.

"Our first case (of fungal meningitis) has been in the hospital for over four weeks on continuous anti-fungal therapy," Latham said.

CLINIC GOT MORE VIALS THAN OTHER FACILITIES

Of the 17,676 vials of steroid suspected of being contaminated, 2,000 vials went to the ninth floor of the Nashville hospital, to St. Thomas Outpatient Neurosurgery Center, more than any other facility in the nation. The clinic is not affiliated with the hospital though it is on the property.

Latham, who has worked around the clock and personally supervised the treatment of every infected person at the hospital, praised the staff.

"My involvement with these patients has also made me a key eyewitness to another extraordinary story -- one of selfless sacrifice and caring among nurses, associates and physicians who have come forward to help in ways that I never imagined," Latham said.

He said hospital employees ranging from telephone operators answering calls from scared patients to heart doctors who volunteered to work in the ER have helped the hospital cope with what was a "horrific" situation.

St. Thomas is not out of the woods yet. On Friday, officials confirmed another 111 patients of the Outpatient Neurosurgery Center in the building may have received tainted medicine from one of the lots as early as early June. Some of them may have to come in for tests.

(Reporting by Tim Ghianni; Writing by Greg McCune; Editing by Cynthia Osterman)

Source: http://news.yahoo.com/center-meningitis-scare-nashville-hospital-battles-save-lives-212556986.html

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2 Americans win Nobel economics prize

STOCKHOLM (AP) ? Americans Alvin Roth and Lloyd Shapley were awarded the Nobel economics prize on Monday for research that helps explain the market processes at work when doctors are assigned to hospitals, students to schools and human organs for transplant to recipients.

The Royal Swedish Academy of Sciences cited the two economists for "the theory of stable allocations and the practice of market design."

Roth, 60, is a professor at Harvard University in Boston. Shapley, 89, is a professor emeritus at University of California Los Angeles.

"This year's prize concerns a central economic problem: how to match different agents as well as possible," the academy said.

Shapley made early theoretical inroads into the subject, using game theory to analyze different matching methods in the 1950s and '60s. Together with U.S. economist David Gale, he examined "pairwise matching," by looking at how 10 women and 10 men could be coupled up, while respecting their individual preferences.

Roth took it further by applying it to the market for U.S. doctors in the '90s.

"Even though these two researchers worked independently of one another, the combination of Shapley's basic theory and Roth's empirical investigations, experiments and practical design has generated a flourishing field of research and improved the performance of many markets," the academy said.

Roth said he was sleeping when he got the call from the prize committee in California, where he is a visiting professor at Stanford University.

"I'm sure that in class this morning my students will pay more attention," he told a news conference in Stockholm by phone.

Asked how he would celebrate, he said: "I haven't made any plans yet; coffee."

The Nobel Memorial Prize in Economic Sciences was the last of the 2012 Nobel awards to be announced.

It's not technically a Nobel Prize, because unlike the five other awards it wasn't established in the will of Alfred Nobel, a Swedish industrialist also known for inventing dynamite.

The economics prize was created by the Swedish central bank in Nobel's memory in 1968, and has been handed out with the other prizes ever since. Each award is worth 8 million Swedish kronor, or about $1.2 million.

Last year's economics prize went to U.S. economists Thomas Sargent and Christopher Sims for describing the cause-and-effect relationship between the economy and government policy.

The 2012 Nobel Prizes in medicine, physics chemistry and literature and the Nobel Peace Prize were announced last week. All awards will be handed out on Dec. 10, the anniversary of Nobel's death in 1896.

Source: http://news.yahoo.com/2-americans-win-nobel-economics-prize-111239568--finance.html

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