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Biotech / Medical : Guilford (GLFD) - Steadily Rising -- Ignore unavailable to you. Want to Upgrade?

To: Miljenko Zuanic who wrote (464)	5/7/2004 7:55:13 PM
From: zeta1961	Respond to of 496

I just found this board...only to find all you guys from the valuation thread... I follow GLFD only peripherally because they make the Gliadel wafer and since my husband died of glioblastoma, I try to keep track of new treatments.... I received this letter from a guy who runs the virtualtrials.org website for brain tumor patients...which impelled me to a dig bit into GLFD to find out their CFO just resigned and earnings are out on Monday.... Perhaps this letter will shed some light...not only for GLFD but underscores the happenings at Medicare and patients with different diseases competing for a piece of the finite Medicare pie...just wanted to share in case anyone here might find it helpful.... Another reason I found it haunting is that the brother of a close friend...in his 60's, retired and on medicare was diagnosed last year...was not offered Gliadel...I was quite surprised... ___________________________________________________________ [....There is a very important issue that will probably pop up later today or next week, where a grassroots movement can make a huge impact on the lives of brain tumor patients. The basic problem is the way Medicare pays for expensive treatments, like gliadel (and this will apply to a few treatments in the pipeline for brain tumors also). Instead of saying they won't pay for these things, which would allow the doctors to give the choice to the patient and allow the patient to decide if it is worth paying for it themselves, they say "Yes - we do pay for it". But they do it is a very sleazy manner. They say that it is include in the payment made to the hospitals for the brain tumor surgery. For example, if you have a brain tumor operation in the hospital, the hospital gets paid around $50,000 (it varies by location and other problems a patient has, but I will use these numbers as an example). That includes the use of the operating room, recovery room, ICU, and hospital room, as well as the staff needed to run it - for as long as the patient stays in the hospital. If you stay 1 day or 10 days, the payment doesn't change. Sounds like a lot of money, but it barely covers the costs if the patient stays for 2 days and the hospital loses money if the patient stays for 3 or more days. (Which is why a typical stay was 7 days 10 years ago and is now about 3 days for a brain tumor operation) Now they are throwing Gliadel into that also. If the doctor inserts the gliadel wafers, the hospital has to pay for the drug, about $12,000. BUT they do not get any extra payment from medicare, so in effect, it costs the hospital $12,000 every time they use gliadel. The worst part is that since Medicare is "paying" for it, the patient is not even allowed to pay for it even if he wants it. The choice is being removed from the doctor and patient all together. The hospitals are pressuring the doctors not to use it and not even mention it as an option to the patients. I had a meeting with the Medicare people about this. Their response was that the way the hospital payment system is set up, hospitals make money on some procedures and lost it on others and it all evens out in the end. What they couldn't understand is that it adds an economic incentive to withhold a treatment option. Medicare told me that no hospital or doctor would let the economic pressure cloud the decision. I talked to doctors who told me that they are forbidden to use gliadel on a medicare patient, and are threatened with being thrown off staff if they use it. Net result: only about 5% of the medicare patients who were probably eligable for using gliadel got it last year. Latest research on gliadel shows a 25% decreased risk of death at the 3 year mark. Later today or next week, Medicare is going to publish the results of my meeting as a proposed rule. I have no idea what it is going to say, but in any event, that opens up a public comment period. We need to generate a huge amount of support to influence this to go our way. We (the drug company, as well as a few of the biggest neurosurgeons in the country were with me) asked for a new code to use when a treatment device is inserted into the brain at the same time as a brain tumor surgery. This would pay for gliadel as well as the next generation of devices coming down the pipeline. We are fighting against other special interest groups who are also fighting for the same thing for what they feel is important. The total number of dollars that medicare has is constant. What is happening is a reshuffling of how it is spent. If we get what we want, someone else has to lose. If someone else gets what they want, we can lose. I talked to the person in charge of this and she told me that they bend to public opinion. They want to help the most people on the money they have. She said we need 10,000 letters to even have a shot at making a difference, and that we should do this no matter what the proposed rule says - even if it is in favor of the new code - since other groups will be fighting for what they want also. Al