News Briefs

OPTN/UNOS to pilot paired donation program

The Organ Procurement and Transplantation Network (OPTN) and the United Network for Organ Sharing (UNOS) board of directors has approved what was termed elements of a pilot national system to facilitate kidney paired donations.

Kidney paired donation involves two or more living donor transplants where the initially intended donor/recipient pairs are medically incompatible; two or more donor/recipient pairs are then crossed to provide a compatible living donor for each recipient.

"The broader the base of people who can be matched, the more paired transplants can be done to help those in need," said Timothy L. Pruett, MD, president of the OPTN and UNOS and chair of the OPTN/UNOS board of directors.

The board's action followed the December 2007 passage of the Charlie W. Norwood Living Organ Donation Act, which the organizations said "clarified the legal basis for paired donation."

The initial pilot system will be voluntary, open to any living donor kidney transplant program meeting OPTN requirements and for any candidate on the OPTN waiting list.

Since 2000, about 350 paired donation transplants have been performed in the United States, according to UNOS.

Survey shows support for physician-assisted suicide

According to a national survey of adults by ELDR magazine and on the issue of physician-assisted suicide, more than 80% of those responding said they believe that the choice to end one's life is a "personal decision."

Two-thirds of the adults said they want physician-assisted suicide made legal, as it is in the state of Oregon.

The publications said that its survey revealed that only half of adults over 60 years old have a living will or advance health care directive.

AMA takes its message on the uninsured to Chicago

As part of its Voice for the Uninsured Campaign, the American Medical Association (AMA) in Chicago is taking its message to the public in that city. The AMA campaign is a three-year, multimillion-collar effort to encourage action to cover individuals who lack health insurance in the United States.

In June, 400 AMA medical students and residents were to attend a Chicago White sox game to talk to Chicago families about the crisis of the uninsured. They were also planning to encourage adults to vote in the November election with a mind toward influencing government efforts to provide insurance for uninsured patients.

"With one one of the top five highest uninsured populations in the U.S., Illinois is not stranger to the tragedies faced daily by uninsured patients," said AMA board member and medical student Chris DeRienzo. "The nearly 2 million uninsured in Illinois, and the tens of millions more living across the U.S., live sicker and die younger, and they deserve better than the status quo."

The campaign features a Web site and will include television ads to air this fall on television stations throughout the country.

Oncologists should think about cost of interventions

Such interventions may increase costs of care

A report appearing in the American Cancer Society's July/August issue of CA: A Cancer Journal for Clinicians suggests that cancer clinicians should understand and consider the economic impact of new interventions, which often have substantial costs.

The report in the peer-reviewed journal says health care budget constraints have made it necessary for clinicians to be mindful of the relative costs and benefits of new interventions used in cancer screening, diagnosis, treatment and support services for patients.

The ACS said the report highlights several examples of new interventions that may help specific populations but result in increased costs. They include magnetic resonance imaging (MRI) screening for breast cancer, which costs $1,000 per image, or 10 times the cost of screening mammography.

Positron emission tomography (PET) costs $1,800 for a scan for cancer staging. Or, consider the $48,000 per patient per year price tag for the use of intensity-modulated radiation therapy to treat prostate cancer.

According to the ACS, the authors write that "unless clinicians, other cancer health care providers, and cancer researchers are active participants in discussions regarding the relative costs and benefits of new interventions, others will make these cost-effectiveness conclusions. Having members of the oncology community exclude themselves from these discussions and from the process of determining costs and benefits of new cancer therapies is unlikely to be in the best interests of cancer patients."

The ACS said that the report reviews the methods used for economic analyses to help clinicians understand how economic evaluations of cancer interventions are performed so they better able to use — and critique — such evaluations.

The report says that clinicians should care about economic analyses for several reasons: patients are increasingly required to pay for a proportion of their medical care; expenditures need to be prioritized to determine the most reasonable use of limited health care funds; and it is important that recommended medical treatments be "good buys."