Showing posts with label Patients. Show all posts
Showing posts with label Patients. Show all posts

Tuesday, January 14, 2014

Midday open thread: the House on Iran, "a little convenient massacre," "Cured" HIV patients relapse

  • Today’s comic by Jen Sorensen is Comic: Nation of moochers:
    Cartoon by Jen Sorensen - Nation of moochers


  • Rep. Sean Maloney will marry his long-time partner:
    With their marriage, Maloney will become the second member of Congress to legally wed his same-sex partner while in office. Former Rep. Barney Frank, D-Massachusetts, became the first to do so in 2012.

    Maloney and [Randy] Florke, who have three adopted children and live in Cold Spring, New York, got engaged on Christmas Day.


    Their youngest daughter, Essie, wrote a letter to Santa earlier that week, asking if he can “try making my wonderful fathers get married.”




  • Markos abandons politics for a few moments to write about cyclist “Fast Freddie” Rodriguez.

  • Jerkwad NY Post columnist calls Newtown “a little convenient massacre”:


    Fredric Dicker, widely regarded as one of the most influential media voices in New York state politics, made the comment on his radio show Monday. He was speaking about gun control legislation passed by the state’s governor, Andrew Cuomo.

    “That was his anti-gun legislation, which he had promised not to do, but then he had a little convenient massacre that went on in Newtown, Conn., and all of a sudden there was an opportunity for him,” Dicker said.



    When the backlash struck, Dicker did not apologize or back down. The rival NY Daily News featured Dicker on its front page Tuesday.


  • Men supposedly cured of HIV by bone marrow transplant relapse:
    These two men were both HIV positive and had lymphoma, a type of cancer. They both received bone marrow transplants. Post-transplant they continued on their antiretroviral medicine (used to combat HIV) while the donor bone marrow cells engrafted. Researchers found that all traces of HIV in the patients vanished.

    They were followed and, in time, both patients stopped their antiretrovirals. They remained HIV free—or so everyone thought, since their viral loads were undetectable and no trace of HIV was found in peripheral blood cells.


    Unfortunately, over time, both relapsed and tests showed HIV was again (still) present.




  • DEA let tech-savvy drug cartel do what it pleased:
    Catapults. “Jalapeños.” Dune buggies. $ 1 million subs. Sophisticated drug tunnels. Firetruck-sized industrial pipeline drills. These are just a few of the ingenious ways that Mexico’s Sinaloa cartel, arguably the world’s largest, most powerful and technologically advanced organized crime syndicate, has tried to perfect the fine art of smuggling drugs into America. And to think, the US’s premier drug enforcement arm gave the Sinaloa a pass to do so largely unhindered during the bloodiest stretch of Mexico’s drug war.

    That’s the thrust of a landmark investigation by El Universal, which found that authorities with the US Drug Enforcement Administration and the broader Department of Justice struck a deal with the Sinaloa, in exchange for intelligence about rival cartels. Citing court documents and extensive interviews with both Mexican and US officials familiar with the matter, El Universal reports that the US-Sinaloa arrangement lasted from 2000 to 2012.




  • These Daily Kos community posts were the most shared on Facebook Jan. 13:

    WV: Freedom Industries Has Ties to Koch Brothers, by dharmafarmer

    “Like a Book Burning” The Canadian government is closing scientific libraries and destroying docs, by Pakalolo


    Inhofe Admits He Only Denies Climate Science Because He Doesn’t Like the Solutions, by TheGreenMiles




  • Picking up seashells down by the seashore is an environmental problem:
    It’s a normal part of summer vacation: head to the beach, pick up a few seashells and take them home as keepsakes. But multiply this innocent activity by millions of tourists and we might have a big problem, researchers warn in PLOS ONE. Skyrocketing numbers of beachcombers are pocketing seashells, and the environmental effects could range from increased erosion to fewer building materials for bird nests.


  • House Republicans could rescue Iran diplomacy: In the Senate, a majority supports adding economic sanctions to those already imposed on Iran, something the Obama administration and the Iranian foreign minister say could wreck efforts to come to agreement on international controls on Iran’s nuclear program. Sixteen Democrats, led by Sen. Bob Menendez of New Jersey have signed onto the sanctions bill introduced in December. Forty-two Senate Republicans have joined. But
    Enter House Republicans. The Wall Street Journal reported Tuesday that House GOP leaders are considering bringing the Senate bill to the House floor, a move that could inject a heavy dose of partisanship into what had been a bipartisan affair. If House Republicans take control of the legislation, Democrats may become more anxious about supporting it and less likely to buck the White House.

    “I’m hearing Cantor wants to take up the Menendez language,” confirmed one senior House Democratic aide. “Since the House has already passed a sanctions bill, it’s quite clear that this has turned into a completely political matter.”






  • On today’s Kagro in the Morning show, the Chris Christie and WV stories aren’t dead yet. Greg Dworkin brought us a round-up of the headlines on Christie and the latest on Obamacare, which is still a thing! Plus: new gun outrage out of FL. A retired police captain shoots a fellow movie-goer for texting during the previews. We return to the WV story for more on just what this spilled chemical is, how dangerous we should consider it to be, and whether or not Koch Industries really is connected to the situation. And just how did a relatively small spill end up contaminating the drinking water of nine counties? The answer, at least in part is privatization.




Daily Kos



Midday open thread: the House on Iran, "a little convenient massacre," "Cured" HIV patients relapse

Midday open thread: the House on Iran, "a little convenient massacre," "Cured" HIV patients relapse

  • Today’s comic by Jen Sorensen is Comic: Nation of moochers:
    Cartoon by Jen Sorensen - Nation of moochers


  • Rep. Sean Maloney will marry his long-time partner:
    With their marriage, Maloney will become the second member of Congress to legally wed his same-sex partner while in office. Former Rep. Barney Frank, D-Massachusetts, became the first to do so in 2012.

    Maloney and [Randy] Florke, who have three adopted children and live in Cold Spring, New York, got engaged on Christmas Day.


    Their youngest daughter, Essie, wrote a letter to Santa earlier that week, asking if he can “try making my wonderful fathers get married.”




  • Markos abandons politics for a few moments to write about cyclist “Fast Freddie” Rodriguez.

  • Jerkwad NY Post columnist calls Newtown “a little convenient massacre”:


    Fredric Dicker, widely regarded as one of the most influential media voices in New York state politics, made the comment on his radio show Monday. He was speaking about gun control legislation passed by the state’s governor, Andrew Cuomo.

    “That was his anti-gun legislation, which he had promised not to do, but then he had a little convenient massacre that went on in Newtown, Conn., and all of a sudden there was an opportunity for him,” Dicker said.



    When the backlash struck, Dicker did not apologize or back down. The rival NY Daily News featured Dicker on its front page Tuesday.


  • Men supposedly cured of HIV by bone marrow transplant relapse:
    These two men were both HIV positive and had lymphoma, a type of cancer. They both received bone marrow transplants. Post-transplant they continued on their antiretroviral medicine (used to combat HIV) while the donor bone marrow cells engrafted. Researchers found that all traces of HIV in the patients vanished.

    They were followed and, in time, both patients stopped their antiretrovirals. They remained HIV free—or so everyone thought, since their viral loads were undetectable and no trace of HIV was found in peripheral blood cells.


    Unfortunately, over time, both relapsed and tests showed HIV was again (still) present.




  • DEA let tech-savvy drug cartel do what it pleased:
    Catapults. “Jalapeños.” Dune buggies. $ 1 million subs. Sophisticated drug tunnels. Firetruck-sized industrial pipeline drills. These are just a few of the ingenious ways that Mexico’s Sinaloa cartel, arguably the world’s largest, most powerful and technologically advanced organized crime syndicate, has tried to perfect the fine art of smuggling drugs into America. And to think, the US’s premier drug enforcement arm gave the Sinaloa a pass to do so largely unhindered during the bloodiest stretch of Mexico’s drug war.

    That’s the thrust of a landmark investigation by El Universal, which found that authorities with the US Drug Enforcement Administration and the broader Department of Justice struck a deal with the Sinaloa, in exchange for intelligence about rival cartels. Citing court documents and extensive interviews with both Mexican and US officials familiar with the matter, El Universal reports that the US-Sinaloa arrangement lasted from 2000 to 2012.




  • These Daily Kos community posts were the most shared on Facebook Jan. 13:

    WV: Freedom Industries Has Ties to Koch Brothers, by dharmafarmer

    “Like a Book Burning” The Canadian government is closing scientific libraries and destroying docs, by Pakalolo


    Inhofe Admits He Only Denies Climate Science Because He Doesn’t Like the Solutions, by TheGreenMiles




  • Picking up seashells down by the seashore is an environmental problem:
    It’s a normal part of summer vacation: head to the beach, pick up a few seashells and take them home as keepsakes. But multiply this innocent activity by millions of tourists and we might have a big problem, researchers warn in PLOS ONE. Skyrocketing numbers of beachcombers are pocketing seashells, and the environmental effects could range from increased erosion to fewer building materials for bird nests.


  • House Republicans could rescue Iran diplomacy: In the Senate, a majority supports adding economic sanctions to those already imposed on Iran, something the Obama administration and the Iranian foreign minister say could wreck efforts to come to agreement on international controls on Iran’s nuclear program. Sixteen Democrats, led by Sen. Bob Menendez of New Jersey have signed onto the sanctions bill introduced in December. Forty-two Senate Republicans have joined. But
    Enter House Republicans. The Wall Street Journal reported Tuesday that House GOP leaders are considering bringing the Senate bill to the House floor, a move that could inject a heavy dose of partisanship into what had been a bipartisan affair. If House Republicans take control of the legislation, Democrats may become more anxious about supporting it and less likely to buck the White House.

    “I’m hearing Cantor wants to take up the Menendez language,” confirmed one senior House Democratic aide. “Since the House has already passed a sanctions bill, it’s quite clear that this has turned into a completely political matter.”






  • On today’s Kagro in the Morning show, the Chris Christie and WV stories aren’t dead yet. Greg Dworkin brought us a round-up of the headlines on Christie and the latest on Obamacare, which is still a thing! Plus: new gun outrage out of FL. A retired police captain shoots a fellow movie-goer for texting during the previews. We return to the WV story for more on just what this spilled chemical is, how dangerous we should consider it to be, and whether or not Koch Industries really is connected to the situation. And just how did a relatively small spill end up contaminating the drinking water of nine counties? The answer, at least in part is privatization.




Daily Kos



Midday open thread: the House on Iran, "a little convenient massacre," "Cured" HIV patients relapse

Saturday, November 2, 2013

Iranian patients suffer most from sanctions

Iranian patients suffer most from sanctions
http://img.youtube.com/vi/54n4SGAhB8Y/0.jpg



Desperately waiting for life-saving medications; this is the fate of many Iranian patients, whose lives are at stake due to the shortage of medicines resulti…
Video Rating: 4 / 5




Read more about Iranian patients suffer most from sanctions and other interesting subjects concerning World News Videos at TheDailyNewsReport.com

How drug companies price patients out of survival

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How drug companies price patients out of survival

Monday, September 23, 2013

Doctors Brace for Surge of Ailing Patients...


Holy Cross Hospital’s health center in Aspen Hill, Maryland, is bracing for more business.


The center treats the uninsured, and has been busy since it opened in 2012 with a waiting list of more than 400 people at its clinic. Now, as a result of the U.S. Affordable Care Act, it’s mulling adding staff and hours in anticipation of next year’s rush of newly-insured patients, many with chronic medical conditions that have gone untreated for years.


Poorly controlled diabetes can cause stroke, kidney failure and blindness. Undiagnosed cancer can translate into complex end-of-life care, and untreated high blood pressure can lead to heart attacks. In effect, the 2010 health law’s biggest promise becomes its most formidable challenge: unprecedented access to care for a needy population when the nation is already grappling with overtaxed emergency rooms and a shortage of physicians.


“When you’re getting people that haven’t had insurance, they have significant health issues,” said Kevin Sexton, president and chief executive officer of Holy Cross Health, in a telephone interview. “A lot of people need these services.”


About 25 million Americans are expected to gain coverage under the health law, commonly known as Obamacare. Starting Oct. 1, as many as 7 million uninsured Americans will begin shopping for private plans through government-run exchanges, with many people eligible to have their premiums subsidized by taxpayers. On Jan. 1, Medicaid programs for low-income people will be expanded in about half the U.S. states.


Strained System


The increase in newly insured patients arrives at a time when the nation has 15,230 fewer primary-care doctors than it needs, according to an Aug. 28 assessment by the U.S. Department of Health and Human Services. And emergency rooms report being strained with visits that have risen at twice the rate of population growth.


“It’s like we’re handing out bus tickets and the bus is already full,” said Perry Pugno, vice president for medical education at the American Academy of Family Physicians, by telephone. “The shortfall of primary-care access is not an insignificant problem, and it’s going to get worse.”


Almost half of all uninsured, non-elderly adults had a chronic condition, based on a 2005 report by the Urban Institute and the University of Maryland. One in six with hypertension reported no visits to health professionals in a year.


Most who come to Holy Cross’s health center now lack insurance, and have lived for years with serious ailments, according to Elise Riley, the center’s medical director. “It’s frustrating to see diseases that could have been prevented,” she said in an interview in her office.


More demand may lead to months-long waits to see doctors, delays in finding specialists, and strains on hospitals and outpatient clinics, others said.


Patient Access


Ensuring patient access is critical to the Affordable Care Act’s success: if the newly insured swamp the medical system, it could hand critics pushing to derail the law another argument to fray public support. Sara Rosenbaum, a health-law professor at George Washington University in Washington, said she doesn’t believe it’s going to happen.


“It’s going to be a slow ramp up,” Rosenbaum said in a telephone interview. “It’s not like seven million people will get insurance at once. They’re not going to all come racing in the door.”


While that number of new patients can be debated, the status of those who do come in the door is not.


Patients who have had gaps in health insurance were more likely to have not gone to a doctor when sick or to have skipped getting prescriptions, according to an April 2013 report by the Commonwealth Fund, a New York-based foundation that works for health-care access. The uninsured were less likely to be up-to-date on recommended cholesterol, blood pressure, colon cancer screenings and mammograms.


Massachusetts Overhaul


Massachusetts pioneered health reform in 2006 when it enacted near universal coverage under then governor Mitt Romney. Community health centers and hospitals that care for a larger share of lower-income residents saw a 12 percent jump in patient volume from 2009 to 2010, with almost 100,000 more visits to safety net hospitals during that time, according to a 2012 report by the Kaiser Family Foundation.


David Longworth, chairman of the Medicine Institute at Ohio’s Cleveland Clinic, was working in Massachusetts when the state passed near universal health coverage.


“Practices closed and patients would wait for eight to nine months to get in,” Longworth said by telephone. “We overwhelmed the primary care health system.”


In cities such as Lawrence, Massachusetts, a former textile city that has long been home to a large immigrant community, doctors have coped with rising volume.


Patient Surplus


The Lawrence Family Medicine Residency, which provides primary care and other medical services to a largely low-income patient population, saw an uptick in patients, said Joseph Gravel, chief medical officer and residency program director.


“When you look at the experience in Massachusetts, it’s going to be bumpy” when Obamacare rolls out, Gravel said in a telephone interview.


The percentage of family doctors in the state accepting new patients has dropped 19 percent in the past seven years and the percentage of internists accepting new patients has fallen 21 percent over nine years, according to a July report by the Massachusetts Medical Society, an advocacy group for patients and physicians. Only about half of family doctors were accepting new patients this year.


The Cleveland Clinic predicts as many as 90,000 new patients in northeast Ohio if everyone signs up for coverage. The health system is working to ramp up its primary care practices in anticipation.


Exciting Challenge


At Grady Health System in Atlanta, more patients are expected, especially at its six outpatient centers. San Francisco General Hospital and Trauma Center in California has some expanded hours its 19 primary care centers. The centers are located in the hospital and out in the community.


“We anticipate an increase in primary care and specialty,” Chief Executive Officer Sue Currin said.


On a recent Friday morning at the Holy Cross clinic in Aspen Hill, Riley donned a white coat and prepared to see patients. While there may be more patients under reform, Riley said an increase in business will be welcome.


“I’ve very excited,” Riley said. “I’ve been dealing with uninsured patients for a long time. If they get coverage, we can prevent a lot of problems.”


To contact the reporter on this story: Stephanie Armour in Washington at sarmour@bloomberg.net


To contact the editor responsible for this story: Reg Gale at rgale5@bloomberg.net




Enlarge image Affordable Care Act Literature

Affordable Care Act Literature


Affordable Care Act Literature


About 25 million Americans are expected to gain coverage under the health law, commonly known as Obamacare.





About 25 million Americans are expected to gain coverage under the health law, commonly known as Obamacare. Photographer: Michael Nagle/Bloomberg




Acorda

4:45



Sept. 20 (Bloomberg) — Ron Cohen, chief executive officer of Acorda Therapeutics Inc., talks about implementation of the Affordable Care Act and its implications for the health-care industry. Cohen speaks with Sara Eisen, Tom Keene and Anna Edwards on Bloomberg Television’s “Surveillance.” Federal Reserve Bank of St. Louis President James Bullard also speaks. (Source: Bloomberg)






Drudge Report Feed



Doctors Brace for Surge of Ailing Patients...

Sunday, June 16, 2013

Breast Cancer Patients Declare Victory as Supreme Court Bars Patenting of Human Genes



Transcript



This is a rush transcript. Copy may not be in its final form.



JUAN GONZ EZ: In a major victory for women’s health, the Supreme Court has unanimously ruled that isolated human genes may not be patented. The case concerned the firm Myriad Genetics’ patent on genes linked to higher risks of hereditary breast and ovarian cancer. The firm owned patents to a gene called BRCA1, or Breast Cancer One, and a similar gene called BRCA2, meaning it had the authority to stop all research on those genes and was the only company that could conduct life-saving tests revealing if women had mutations in those genes.


AMY GOODMAN: On Thursday, the Supreme Court sided with the American Civil Liberties Union in saying Myriad Genetics’ discovery of the precise location and sequence of the genes did not constitute a “human-made invention” eligible for patenting. The ACLU and the Public Patent Foundation filed the case four years ago on behalf of 20 plaintiffs, including organizations representing over 150,000 medical professionals, geneticists, breast cancer and women’s health advocacy groups, and patients. They made this video to raise awareness.


ACLU VIDEO: Right now, a private company called Myriad Genetics owns a piece of your body. That’s a really bad idea. It patented two genes: Breast Cancer One and Two, or BRCA1 and 2. Certain mutations on these genes give women a strong chance of getting breast or ovarian cancer. The problem is Myriad Genetics says, because of the patents, it’s the only one allowed to test these genes. That’s more than a bad idea. The law says no one can get a patent on products of nature or laws of nature. But Myriad says, once it removes the genes from your body, it owns them. That’s not how the law works.



JUAN GONZÁLEZ: The issue of genetic testing for inherited health risks gained publicity last month when actress Angelina Jolie revealed she underwent a double mastectomy after finding out she had a roughly 87 percent chance of developing breast cancer. In an op-ed piece for The New York Times, Jolie wrote, quote, “I hope that other women can benefit from my experience. Cancer is still a word that strikes fear into people’s hearts, producing a deep sense of powerlessness. But today it is possible to find out through a blood test whether you are highly susceptible to breast and ovarian cancer, and then take action.” Jolie said the cost of testing, at more than $ 3,000 in the United States, remained an obstacle for many women.


AMY GOODMAN: Democracy Now! invited Myriad Genetics to join us on the show, but they declined. When we spoke to company spokesperson Ron Rogers on the phone, he insisted Myriad Genetics offered life-saving genetic testing at an affordable cost.


RON ROGERS: For patients in need, Myriad does provide free testing or financial assistance, depending on the patient’s level of need. So we do have patient assistance programs that patients who are uninsured or who are in financial need can access and to help them get the test. But the vast majority of patients will be able to get this test with no out-of-pocket expense at all. And for those in private insurance plans that are not yet under the umbrella of the Affordable Care Act—and eventually they probably all will be, but for those that are not yet under that umbrella, the average out-of-pocket cost is $ 92. So, it’s much—it’s far fewer than 1 percent of patients that ever have to pay list price for the test, right? I mean, that’s just not—I mean, it’s not even half of 1 percent of patients that have to do that.



JUAN GONZÁLEZ: That was Ron Rogers, spokesperson for Myriad Genetics.


Well, our next guest had quite a difference experience when she tried to get the gene test through his company. We go now to Boston, where we’re joined by Lisbeth Ceriani. She was one of the plaintiffs in the ACLU lawsuit. In 2008, she was diagnosed with an aggressive form of breast cancer. Her oncologist noted she was also at high risk for developing ovarian cancer, and recommended she get the BRCA genetic test. But due to patent laws, the test was prohibitively expensive even though she was insured by MassHealth at the time.


We’re also joined by Sandra Park, a senior attorney with the ACLU’s Women’s Rights Project. She’s one of the lead counsels in the Supreme Court case on gene patenting.


AMY GOODMAN: And in London, we’re joined by Judge Robert Sweet, senior federal judge for the Southern District of New York. He ruled against Myriad Genetics in 2010 and invalidated their patents on the BRCA1 and 2 genes in this case the Supreme Court just ruled on.


We welcome you all to Democracy Now! Judge Sweet, let’s begin with you. This certainly is a victory, the upholding of your decision. How significant is it, nine to zero?


JUDGE ROBERT SWEET: Well, I think the principle that’s enunciated by Justice Thomas’s opinion is a very powerful one. And I think it will have an immediate effect on people like those represented by the plaintiffs’ groups and so on. But the court itself recognized that the study of genomics is one of the leading areas of research in the United States, and it’s very important to everybody’s health. This decision, I believe, will free up the ability of researchers and others to experiment, to deal with genome—genomes, generally. And that, I think, will expand the area of knowledge and research. So I think it’s a very important decision. It’s one that, frankly, I just feel so delighted that I was able to have a part in it, because I think this issue of knowledge and the freedom of genomic knowledge is something that will be critical in the years to come.


JUAN GONZÁLEZ: And, Judge Sweet, the high court’s decision did make a distinction between the patenting of genes that exist in nature versus ones that are somehow or other altered by a firm in the process of their own scientific experimentation.


JUDGE ROBERT SWEET: Yes. I think it really is a simple but an elegant decision, because the court has made it clear that there are areas in research that can perhaps be patented. That’s for another day, with respect to each one. But that is because they have made a change in the gene. And it’s that change—so, the court has not closed down the ability of people to advance medical research through patents, but at the same time, it has made it clear that the—that no one can patent a genome in itself. So that, I think, will open up a greater ability of people to obtain information on the BRCA1 and 2, and it will also enhance the ability of the researchers to deal with genomic research, which is now, as I understand, not only a question of one genome, but the effect genomes on each other. So that freedom, I think, is very important.


AMY GOODMAN: And BRCA1 and 2 is also pronounced “brack one and two.” Lisbeth Ceriani, yours is one of the cases that led to this Supreme Court decision, that first Judge Sweet ruled on, and then the Supreme Court ruled on. Very briefly, if you could tell us your story?


LISBETH CERIANI: Sure. I had difficulty obtaining the BRCA analysis test because I was told by the genetic counselor that they wouldn’t accept my insurance, that my insurance wouldn’t cover it, actually. When I contacted my insurer, they said they would cover it if it was provided by a contracted lab. And I contacted Myriad and said, “Please contract with my insurance.” And that wasn’t happening. They chose not to contract with my insurance, which was at the time Massachusetts MassHealth. And, you know, that was within their right, but, as you know, the test was extremely expensive, so it did take over a year and a half for me to finally access the test through a grant, luckily.


JUAN GONZÁLEZ: Well, you heard the spokesman for Myriad say that very few people actually have to pay list price. And he, Ron Rogers, yesterday insisted his company made the gene test highly accessible.


RON ROGERS: Let’s take a step back and talk about access to the test. The BRCA analysis test for hereditary breast and ovarian cancer is very widely accessible. In fact, essentially all private insurance companies, Medicare and Medicaid provide reimbursement for at-risk patients for BRCA analysis. And also, because of the Affordable Care Act—some people refer to it as “Obamacare”—under the preventive care provisions of the Affordable Care Act, patients can actually get the BRCA analysis test without any out-of-pocket cost, meaning no copayment, no deductible. So they can get the test with no cost at all. For the private insurance plans—and there’s still a small percentage of the private insurance plans that are not yet under the umbrella of the Affordable Care Act—for those private insurance plans, the average out-of-pocket cost for the patient is $ 92, so it’s less than $ 100.



JUAN GONZÁLEZ: Could you respond to that?


LISBETH CERIANI: In my case, it would have been close to $ 4,000 for me to access the test in 2009. They were—Myriad was choosing not to contract with Massachusetts Medicaid at the time. And many negotiations went back and forth between the contracting people with MassHealth and the contracting people at Myriad. So, in my case, it would have been close to $ 4,000. And apparently, they weren’t allowed to offer me any financial—financial deals on the price, because I did have MassHealth, so they were prohibited from offering me any financial discounts. So that was just prohibitive for me to pay at that time. So, luckily, I was able to access a grant in enough time to get the information I needed in order to assess whether I had an increased risk of developing ovarian cancer. And in my case, it turned out I did have a rare mutation, so it was lucky I was able to access the test when I did, but it did take over a year and a half for me, actively working on it like a part-time job. And I just knew that there were other women, who—definitely other women in Massachusetts with the same issues.


AMY GOODMAN: Sandra Park, you were a part of the team that argued this before the Supreme Court. The significance of this victory?


SANDRA PARK: It’s a huge victory. I think that what we had up to this point is a company that monopolized two human genes—genes that we all have in our bodies—and with that monopoly, dictated the terms of testing. So what you’ve heard from Lisbeth is they decide what the price was, with absolutely no competition. And they also decide which mutations that are looked for. They decide the quality of the test.


And what we now know is that there are many laboratories that are fully capable of offering this kind of testing, that would offer it in very different ways, so that they would be looking at the many genes that are connected with breast and ovarian cancer, and not just screening two. And so, with the ruling today, we fully expect much better access and much better options for patients, as well as for scientists who want to look at different parts of the genome. They no longer now need to deal with patents on the thousands of genes on our genome when they’re engaging in their scientific work.


JUAN GONZÁLEZ: And the direct impact immediately of this decision in terms of the availability of testing, not only for this, because this obviously has ramifications beyond these two particular genes, in terms of what’s going to happen in the industry?


SANDRA PARK: Right. Well, with these two genes, we’ve already heard two or three different laboratories have announced they plan to offer testing on the BRCA genes within the year. So it’s already had that immediate effect. But you’re absolutely right, the patent office has issued patents on thousands of human genes connected with diseases like muscular dystrophy, colon cancer. And so, what we expect to see is that patents on those genes will—are seriously under question with the ruling, and more options will become available.


AMY GOODMAN: I wanted to turn to Myriad Genetics’ lawyer, Gregory Castanias, tried to suggest patenting a gene is much like patenting a baseball bat. This is during oral arguments. He said a baseball bat doesn’t exist unless it’s isolated from a tree, but it’s still a product of human invention. Chief Justice Roberts took issue with the argument.


CHIEF JUSTICE JOHN ROBERTS: My understanding is that here what’s involved—obviously, through scientific processes, but we’re not talking about process—here what’s involved is snipping. You’ve got the thing there, and you snip—snip off the top, and you snip off the bottom, and there you’ve got it. The baseball bat is quite different. You don’t look at a tree and say, “Well, I’ll cut the branch here and cut it here, and all of a sudden I’ve got a baseball bat.” You have to invent it, if you will. You don’t have to invent the particular segment of the strand; you just have to cut it off.



AMY GOODMAN: During the hearing, Justice Sonia Sotomayor questioned Myriad Genetics’ lawyer. She compared patenting a gene to someone trying to patent the ingredients used to make chocolate chip cookies, such as sugar and flour.


JUSTICE SONIA SOTOMAYOR: I can bake a chocolate chip cookie using natural ingredients—salt, flour, eggs, butter. And I create my chocolate chip cookie. And if I combust those in some new way, I can get a patent on that. But I can’t imagine getting a patent simply on the basic items of salt, flour and eggs, simply because I’ve created a new use or a new product from those ingredients.



GREGORY CASTANIAS: And that’s—



JUSTICE SONIA SOTOMAYOR: Explain to me—



GREGORY CASTANIAS: Sure.



JUSTICE SONIA SOTOMAYOR: —why gene sequences, whether in the actual numbers, why gene sequences are not those basic products that you can’t patent.



GREGORY CASTANIAS: OK. I’ll start by showing you how this is actually a different structure. It actually has an entirely different chemical name when you give it the C—



JUSTICE SONIA SOTOMAYOR: That’s the cDNA.



GREGORY CASTANIAS: No, no, no. That’s absolutely true with regard—



JUSTICE SONIA SOTOMAYOR: Oh, only if your—



GREGORY CASTANIAS: —to the isolated molecule, as well, because if you were to write it out in those interminable chemical equations that you had to do in high school—



JUSTICE SONIA SOTOMAYOR: So, I put—



GREGORY CASTANIAS: —it’s a “C” very different, “H” very different.



JUSTICE SONIA SOTOMAYOR: I put salt in flour, and that’s different?



GREGORY CASTANIAS: Well, that is—



JUSTICE SONIA SOTOMAYOR: That’s—



GREGORY CASTANIAS: That is a combination, yes, of two different things. And that’s sort of like—that’s sort of like—



JUSTICE SONIA SOTOMAYOR: So if I take them apart, now you can get a patent on the salt, and now you can get a patent on the flour?



GREGORY CASTANIAS: Well, they were apart before, and they—but they were both old. That’s the problem with using the really simplistic analogies, with all due respect, Your Honor.



AMY GOODMAN: That was Justice Sonia Sotomayor questioning Myriad Genetics’ lawyer. Judge Sweet, your response on the significance of this ruling?


JUDGE ROBERT SWEET: Well, what the fundamental issue was—the issue was: Can you patent something that is a product of nature? Can you patent gold, and—for example? And what this decision has affirmed is that there are things in nature that cannot be patented. And one of those things in nature is your genome. It is a peculiar development that is natural. It is not the product of any outside influence. It is your genome, and that can’t be patented.


So the issue really is the extent to which your genome can be, if you will, grasped for some other purpose. And I think the court—I attended the argument. The justices were marvelously attentive. And I think the simple, direct and powerful nine-to-nothing decision indicates that they believe the genome is something that is important to be, if you will—not using it in a legal sense—but free. And it will make a difference, I believe, both in terms of availability for those who want the tests and also in terms of research. So, my view of it is that it is quite an—well, I know it’s an important and long-range decision. And—


AMY GOODMAN: Judge Robert Sweet, we’re going to have to leave it—we’re going to leave it there, and I thank you so much for being with us. Also, I know your clerks just got together and celebrated your 90th birthday. Happy birthday, Judge Robert Sweet. Also, thanks so much to Sandra Park and Lisbeth Ceriani.




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Democracy Now!

Breast Cancer Patients Declare Victory as Supreme Court Bars Patenting of Human Genes

Saturday, June 15, 2013

Breast Cancer Patients Declare Victory as Supreme Court Bars Patenting of Human Genes



Transcript



This is a rush transcript. Copy may not be in its final form.



JUAN GONZÁLEZ: In a major victory for women’s health, the Supreme Court has unanimously ruled that isolated human genes may not be patented. The case concerned the firm Myriad Genetics’ patent on genes linked to higher risks of hereditary breast and ovarian cancer. The firm owned patents to a gene called BRCA1, or Breast Cancer One, and a similar gene called BRCA2, meaning it had the authority to stop all research on those genes and was the only company that could conduct life-saving tests revealing if women had mutations in those genes.


AMY GOODMAN: On Thursday, the Supreme Court sided with the American Civil Liberties Union in saying Myriad Genetics’ discovery of the precise location and sequence of the genes did not constitute a “human-made invention” eligible for patenting. The ACLU and the Public Patent Foundation filed the case four years ago on behalf of 20 plaintiffs, including organizations representing over 150,000 medical professionals, geneticists, breast cancer and women’s health advocacy groups, and patients. They made this video to raise awareness.


ACLU VIDEO: Right now, a private company called Myriad Genetics owns a piece of your body. That’s a really bad idea. It patented two genes: Breast Cancer One and Two, or BRCA1 and 2. Certain mutations on these genes give women a strong chance of getting breast or ovarian cancer. The problem is Myriad Genetics says, because of the patents, it’s the only one allowed to test these genes. That’s more than a bad idea. The law says no one can get a patent on products of nature or laws of nature. But Myriad says, once it removes the genes from your body, it owns them. That’s not how the law works.



JUAN GONZÁLEZ: The issue of genetic testing for inherited health risks gained publicity last month when actress Angelina Jolie revealed she underwent a double mastectomy after finding out she had a roughly 87 percent chance of developing breast cancer. In an op-ed piece for The New York Times, Jolie wrote, quote, “I hope that other women can benefit from my experience. Cancer is still a word that strikes fear into people’s hearts, producing a deep sense of powerlessness. But today it is possible to find out through a blood test whether you are highly susceptible to breast and ovarian cancer, and then take action.” Jolie said the cost of testing, at more than $ 3,000 in the United States, remained an obstacle for many women.


AMY GOODMAN: Democracy Now! invited Myriad Genetics to join us on the show, but they declined. When we spoke to company spokesperson Ron Rogers on the phone, he insisted Myriad Genetics offered life-saving genetic testing at an affordable cost.


RON ROGERS: For patients in need, Myriad does provide free testing or financial assistance, depending on the patient’s level of need. So we do have patient assistance programs that patients who are uninsured or who are in financial need can access and to help them get the test. But the vast majority of patients will be able to get this test with no out-of-pocket expense at all. And for those in private insurance plans that are not yet under the umbrella of the Affordable Care Act—and eventually they probably all will be, but for those that are not yet under that umbrella, the average out-of-pocket cost is $ 92. So, it’s much—it’s far fewer than 1 percent of patients that ever have to pay list price for the test, right? I mean, that’s just not—I mean, it’s not even half of 1 percent of patients that have to do that.



JUAN GONZÁLEZ: That was Ron Rogers, spokesperson for Myriad Genetics.


Well, our next guest had quite a difference experience when she tried to get the gene test through his company. We go now to Boston, where we’re joined by Lisbeth Ceriani. She was one of the plaintiffs in the ACLU lawsuit. In 2008, she was diagnosed with an aggressive form of breast cancer. Her oncologist noted she was also at high risk for developing ovarian cancer, and recommended she get the BRCA genetic test. But due to patent laws, the test was prohibitively expensive even though she was insured by MassHealth at the time.


We’re also joined by Sandra Park, a senior attorney with the ACLU’s Women’s Rights Project. She’s one of the lead counsels in the Supreme Court case on gene patenting.


AMY GOODMAN: And in London, we’re joined by Judge Robert Sweet, senior federal judge for the Southern District of New York. He ruled against Myriad Genetics in 2010 and invalidated their patents on the BRCA1 and 2 genes in this case the Supreme Court just ruled on.


We welcome you all to Democracy Now! Judge Sweet, let’s begin with you. This certainly is a victory, the upholding of your decision. How significant is it, nine to zero?


JUDGE ROBERT SWEET: Well, I think the principle that’s enunciated by Justice Thomas’s opinion is a very powerful one. And I think it will have an immediate effect on people like those represented by the plaintiffs’ groups and so on. But the court itself recognized that the study of genomics is one of the leading areas of research in the United States, and it’s very important to everybody’s health. This decision, I believe, will free up the ability of researchers and others to experiment, to deal with genome—genomes, generally. And that, I think, will expand the area of knowledge and research. So I think it’s a very important decision. It’s one that, frankly, I just feel so delighted that I was able to have a part in it, because I think this issue of knowledge and the freedom of genomic knowledge is something that will be critical in the years to come.


JUAN GONZÁLEZ: And, Judge Sweet, the high court’s decision did make a distinction between the patenting of genes that exist in nature versus ones that are somehow or other altered by a firm in the process of their own scientific experimentation.


JUDGE ROBERT SWEET: Yes. I think it really is a simple but an elegant decision, because the court has made it clear that there are areas in research that can perhaps be patented. That’s for another day, with respect to each one. But that is because they have made a change in the gene. And it’s that change—so, the court has not closed down the ability of people to advance medical research through patents, but at the same time, it has made it clear that the—that no one can patent a genome in itself. So that, I think, will open up a greater ability of people to obtain information on the BRCA1 and 2, and it will also enhance the ability of the researchers to deal with genomic research, which is now, as I understand, not only a question of one genome, but the effect genomes on each other. So that freedom, I think, is very important.


AMY GOODMAN: And BRCA1 and 2 is also pronounced “brack one and two.” Lisbeth Ceriani, yours is one of the cases that led to this Supreme Court decision, that first Judge Sweet ruled on, and then the Supreme Court ruled on. Very briefly, if you could tell us your story?


LISBETH CERIANI: Sure. I had difficulty obtaining the BRCA analysis test because I was told by the genetic counselor that they wouldn’t accept my insurance, that my insurance wouldn’t cover it, actually. When I contacted my insurer, they said they would cover it if it was provided by a contracted lab. And I contacted Myriad and said, “Please contract with my insurance.” And that wasn’t happening. They chose not to contract with my insurance, which was at the time Massachusetts MassHealth. And, you know, that was within their right, but, as you know, the test was extremely expensive, so it did take over a year and a half for me to finally access the test through a grant, luckily.


JUAN GONZÁLEZ: Well, you heard the spokesman for Myriad say that very few people actually have to pay list price. And he, Ron Rogers, yesterday insisted his company made the gene test highly accessible.


RON ROGERS: Let’s take a step back and talk about access to the test. The BRCA analysis test for hereditary breast and ovarian cancer is very widely accessible. In fact, essentially all private insurance companies, Medicare and Medicaid provide reimbursement for at-risk patients for BRCA analysis. And also, because of the Affordable Care Act—some people refer to it as “Obamacare”—under the preventive care provisions of the Affordable Care Act, patients can actually get the BRCA analysis test without any out-of-pocket cost, meaning no copayment, no deductible. So they can get the test with no cost at all. For the private insurance plans—and there’s still a small percentage of the private insurance plans that are not yet under the umbrella of the Affordable Care Act—for those private insurance plans, the average out-of-pocket cost for the patient is $ 92, so it’s less than $ 100.



JUAN GONZÁLEZ: Could you respond to that?


LISBETH CERIANI: In my case, it would have been close to $ 4,000 for me to access the test in 2009. They were—Myriad was choosing not to contract with Massachusetts Medicaid at the time. And many negotiations went back and forth between the contracting people with MassHealth and the contracting people at Myriad. So, in my case, it would have been close to $ 4,000. And apparently, they weren’t allowed to offer me any financial—financial deals on the price, because I did have MassHealth, so they were prohibited from offering me any financial discounts. So that was just prohibitive for me to pay at that time. So, luckily, I was able to access a grant in enough time to get the information I needed in order to assess whether I had an increased risk of developing ovarian cancer. And in my case, it turned out I did have a rare mutation, so it was lucky I was able to access the test when I did, but it did take over a year and a half for me, actively working on it like a part-time job. And I just knew that there were other women, who—definitely other women in Massachusetts with the same issues.


AMY GOODMAN: Sandra Park, you were a part of the team that argued this before the Supreme Court. The significance of this victory?


SANDRA PARK: It’s a huge victory. I think that what we had up to this point is a company that monopolized two human genes—genes that we all have in our bodies—and with that monopoly, dictated the terms of testing. So what you’ve heard from Lisbeth is they decide what the price was, with absolutely no competition. And they also decide which mutations that are looked for. They decide the quality of the test.


And what we now know is that there are many laboratories that are fully capable of offering this kind of testing, that would offer it in very different ways, so that they would be looking at the many genes that are connected with breast and ovarian cancer, and not just screening two. And so, with the ruling today, we fully expect much better access and much better options for patients, as well as for scientists who want to look at different parts of the genome. They no longer now need to deal with patents on the thousands of genes on our genome when they’re engaging in their scientific work.


JUAN GONZÁLEZ: And the direct impact immediately of this decision in terms of the availability of testing, not only for this, because this obviously has ramifications beyond these two particular genes, in terms of what’s going to happen in the industry?


SANDRA PARK: Right. Well, with these two genes, we’ve already heard two or three different laboratories have announced they plan to offer testing on the BRCA genes within the year. So it’s already had that immediate effect. But you’re absolutely right, the patent office has issued patents on thousands of human genes connected with diseases like muscular dystrophy, colon cancer. And so, what we expect to see is that patents on those genes will—are seriously under question with the ruling, and more options will become available.


AMY GOODMAN: I wanted to turn to Myriad Genetics’ lawyer, Gregory Castanias, tried to suggest patenting a gene is much like patenting a baseball bat. This is during oral arguments. He said a baseball bat doesn’t exist unless it’s isolated from a tree, but it’s still a product of human invention. Chief Justice Roberts took issue with the argument.


CHIEF JUSTICE JOHN ROBERTS: My understanding is that here what’s involved—obviously, through scientific processes, but we’re not talking about process—here what’s involved is snipping. You’ve got the thing there, and you snip—snip off the top, and you snip off the bottom, and there you’ve got it. The baseball bat is quite different. You don’t look at a tree and say, “Well, I’ll cut the branch here and cut it here, and all of a sudden I’ve got a baseball bat.” You have to invent it, if you will. You don’t have to invent the particular segment of the strand; you just have to cut it off.



AMY GOODMAN: During the hearing, Justice Sonia Sotomayor questioned Myriad Genetics’ lawyer. She compared patenting a gene to someone trying to patent the ingredients used to make chocolate chip cookies, such as sugar and flour.


JUSTICE SONIA SOTOMAYOR: I can bake a chocolate chip cookie using natural ingredients—salt, flour, eggs, butter. And I create my chocolate chip cookie. And if I combust those in some new way, I can get a patent on that. But I can’t imagine getting a patent simply on the basic items of salt, flour and eggs, simply because I’ve created a new use or a new product from those ingredients.



GREGORY CASTANIAS: And that’s—



JUSTICE SONIA SOTOMAYOR: Explain to me—



GREGORY CASTANIAS: Sure.



JUSTICE SONIA SOTOMAYOR: —why gene sequences, whether in the actual numbers, why gene sequences are not those basic products that you can’t patent.



GREGORY CASTANIAS: OK. I’ll start by showing you how this is actually a different structure. It actually has an entirely different chemical name when you give it the C—



JUSTICE SONIA SOTOMAYOR: That’s the cDNA.



GREGORY CASTANIAS: No, no, no. That’s absolutely true with regard—



JUSTICE SONIA SOTOMAYOR: Oh, only if your—



GREGORY CASTANIAS: —to the isolated molecule, as well, because if you were to write it out in those interminable chemical equations that you had to do in high school—



JUSTICE SONIA SOTOMAYOR: So, I put—



GREGORY CASTANIAS: —it’s a “C” very different, “H” very different.



JUSTICE SONIA SOTOMAYOR: I put salt in flour, and that’s different?



GREGORY CASTANIAS: Well, that is—



JUSTICE SONIA SOTOMAYOR: That’s—



GREGORY CASTANIAS: That is a combination, yes, of two different things. And that’s sort of like—that’s sort of like—



JUSTICE SONIA SOTOMAYOR: So if I take them apart, now you can get a patent on the salt, and now you can get a patent on the flour?



GREGORY CASTANIAS: Well, they were apart before, and they—but they were both old. That’s the problem with using the really simplistic analogies, with all due respect, Your Honor.



AMY GOODMAN: That was Justice Sonia Sotomayor questioning Myriad Genetics’ lawyer. Judge Sweet, your response on the significance of this ruling?


JUDGE ROBERT SWEET: Well, what the fundamental issue was—the issue was: Can you patent something that is a product of nature? Can you patent gold, and—for example? And what this decision has affirmed is that there are things in nature that cannot be patented. And one of those things in nature is your genome. It is a peculiar development that is natural. It is not the product of any outside influence. It is your genome, and that can’t be patented.


So the issue really is the extent to which your genome can be, if you will, grasped for some other purpose. And I think the court—I attended the argument. The justices were marvelously attentive. And I think the simple, direct and powerful nine-to-nothing decision indicates that they believe the genome is something that is important to be, if you will—not using it in a legal sense—but free. And it will make a difference, I believe, both in terms of availability for those who want the tests and also in terms of research. So, my view of it is that it is quite an—well, I know it’s an important and long-range decision. And—


AMY GOODMAN: Judge Robert Sweet, we’re going to have to leave it—we’re going to leave it there, and I thank you so much for being with us. Also, I know your clerks just got together and celebrated your 90th birthday. Happy birthday, Judge Robert Sweet. Also, thanks so much to Sandra Park and Lisbeth Ceriani.




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Democracy Now!

Breast Cancer Patients Declare Victory as Supreme Court Bars Patenting of Human Genes

Friday, June 14, 2013

Breast Cancer Patients Declare Victory as Supreme Court Bars Patenting of Human Genes



Transcript



This is a rush transcript. Copy may not be in its final form.



JUAN GONZÁLEZ: In a major victory for women’s health, the Supreme Court has unanimously ruled that isolated human genes may not be patented. The case concerned the firm Myriad Genetics’ patent on genes linked to higher risks of hereditary breast and ovarian cancer. The firm owned patents to a gene called BRCA1, or Breast Cancer One, and a similar gene called BRCA2, meaning it had the authority to stop all research on those genes and was the only company that could conduct life-saving tests revealing if women had mutations in those genes.


AMY GOODMAN: On Thursday, the Supreme Court sided with the American Civil Liberties Union in saying Myriad Genetics’ discovery of the precise location and sequence of the genes did not constitute a “human-made invention” eligible for patenting. The ACLU and the Public Patent Foundation filed the case four years ago on behalf of 20 plaintiffs, including organizations representing over 150,000 medical professionals, geneticists, breast cancer and women’s health advocacy groups, and patients. They made this video to raise awareness.


ACLU VIDEO: Right now, a private company called Myriad Genetics owns a piece of your body. That’s a really bad idea. It patented two genes: Breast Cancer One and Two, or BRCA1 and 2. Certain mutations on these genes give women a strong chance of getting breast or ovarian cancer. The problem is Myriad Genetics says, because of the patents, it’s the only one allowed to test these genes. That’s more than a bad idea. The law says no one can get a patent on products of nature or laws of nature. But Myriad says, once it removes the genes from your body, it owns them. That’s not how the law works.



JUAN GONZÁLEZ: The issue of genetic testing for inherited health risks gained publicity last month when actress Angelina Jolie revealed she underwent a double mastectomy after finding out she had a roughly 87 percent chance of developing breast cancer. In an op-ed piece for The New York Times, Jolie wrote, quote, “I hope that other women can benefit from my experience. Cancer is still a word that strikes fear into people’s hearts, producing a deep sense of powerlessness. But today it is possible to find out through a blood test whether you are highly susceptible to breast and ovarian cancer, and then take action.” Jolie said the cost of testing, at more than $ 3,000 in the United States, remained an obstacle for many women.


AMY GOODMAN: Democracy Now! invited Myriad Genetics to join us on the show, but they declined. When we spoke to company spokesperson Ron Rogers on the phone, he insisted Myriad Genetics offered life-saving genetic testing at an affordable cost.


RON ROGERS: For patients in need, Myriad does provide free testing or financial assistance, depending on the patient’s level of need. So we do have patient assistance programs that patients who are uninsured or who are in financial need can access and to help them get the test. But the vast majority of patients will be able to get this test with no out-of-pocket expense at all. And for those in private insurance plans that are not yet under the umbrella of the Affordable Care Act—and eventually they probably all will be, but for those that are not yet under that umbrella, the average out-of-pocket cost is $ 92. So, it’s much—it’s far fewer than 1 percent of patients that ever have to pay list price for the test, right? I mean, that’s just not—I mean, it’s not even half of 1 percent of patients that have to do that.



JUAN GONZÁLEZ: That was Ron Rogers, spokesperson for Myriad Genetics.


Well, our next guest had quite a difference experience when she tried to get the gene test through his company. We go now to Boston, where we’re joined by Lisbeth Ceriani. She was one of the plaintiffs in the ACLU lawsuit. In 2008, she was diagnosed with an aggressive form of breast cancer. Her oncologist noted she was also at high risk for developing ovarian cancer, and recommended she get the BRCA genetic test. But due to patent laws, the test was prohibitively expensive even though she was insured by MassHealth at the time.


We’re also joined by Sandra Park, a senior attorney with the ACLU’s Women’s Rights Project. She’s one of the lead counsels in the Supreme Court case on gene patenting.


AMY GOODMAN: And in London, we’re joined by Judge Robert Sweet, senior federal judge for the Southern District of New York. He ruled against Myriad Genetics in 2010 and invalidated their patents on the BRCA1 and 2 genes in this case the Supreme Court just ruled on.


We welcome you all to Democracy Now! Judge Sweet, let’s begin with you. This certainly is a victory, the upholding of your decision. How significant is it, nine to zero?


JUDGE ROBERT SWEET: Well, I think the principle that’s enunciated by Justice Thomas’s opinion is a very powerful one. And I think it will have an immediate effect on people like those represented by the plaintiffs’ groups and so on. But the court itself recognized that the study of genomics is one of the leading areas of research in the United States, and it’s very important to everybody’s health. This decision, I believe, will free up the ability of researchers and others to experiment, to deal with genome—genomes, generally. And that, I think, will expand the area of knowledge and research. So I think it’s a very important decision. It’s one that, frankly, I just feel so delighted that I was able to have a part in it, because I think this issue of knowledge and the freedom of genomic knowledge is something that will be critical in the years to come.


JUAN GONZÁLEZ: And, Judge Sweet, the high court’s decision did make a distinction between the patenting of genes that exist in nature versus ones that are somehow or other altered by a firm in the process of their own scientific experimentation.


JUDGE ROBERT SWEET: Yes. I think it really is a simple but an elegant decision, because the court has made it clear that there are areas in research that can perhaps be patented. That’s for another day, with respect to each one. But that is because they have made a change in the gene. And it’s that change—so, the court has not closed down the ability of people to advance medical research through patents, but at the same time, it has made it clear that the—that no one can patent a genome in itself. So that, I think, will open up a greater ability of people to obtain information on the BRCA1 and 2, and it will also enhance the ability of the researchers to deal with genomic research, which is now, as I understand, not only a question of one genome, but the effect genomes on each other. So that freedom, I think, is very important.


AMY GOODMAN: And BRCA1 and 2 is also pronounced “brack one and two.” Lisbeth Ceriani, yours is one of the cases that led to this Supreme Court decision, that first Judge Sweet ruled on, and then the Supreme Court ruled on. Very briefly, if you could tell us your story?


LISBETH CERIANI: Sure. I had difficulty obtaining the BRCA analysis test because I was told by the genetic counselor that they wouldn’t accept my insurance, that my insurance wouldn’t cover it, actually. When I contacted my insurer, they said they would cover it if it was provided by a contracted lab. And I contacted Myriad and said, “Please contract with my insurance.” And that wasn’t happening. They chose not to contract with my insurance, which was at the time Massachusetts MassHealth. And, you know, that was within their right, but, as you know, the test was extremely expensive, so it did take over a year and a half for me to finally access the test through a grant, luckily.


JUAN GONZÁLEZ: Well, you heard the spokesman for Myriad say that very few people actually have to pay list price. And he, Ron Rogers, yesterday insisted his company made the gene test highly accessible.


RON ROGERS: Let’s take a step back and talk about access to the test. The BRCA analysis test for hereditary breast and ovarian cancer is very widely accessible. In fact, essentially all private insurance companies, Medicare and Medicaid provide reimbursement for at-risk patients for BRCA analysis. And also, because of the Affordable Care Act—some people refer to it as “Obamacare”—under the preventive care provisions of the Affordable Care Act, patients can actually get the BRCA analysis test without any out-of-pocket cost, meaning no copayment, no deductible. So they can get the test with no cost at all. For the private insurance plans—and there’s still a small percentage of the private insurance plans that are not yet under the umbrella of the Affordable Care Act—for those private insurance plans, the average out-of-pocket cost for the patient is $ 92, so it’s less than $ 100.



JUAN GONZÁLEZ: Could you respond to that?


LISBETH CERIANI: In my case, it would have been close to $ 4,000 for me to access the test in 2009. They were—Myriad was choosing not to contract with Massachusetts Medicaid at the time. And many negotiations went back and forth between the contracting people with MassHealth and the contracting people at Myriad. So, in my case, it would have been close to $ 4,000. And apparently, they weren’t allowed to offer me any financial—financial deals on the price, because I did have MassHealth, so they were prohibited from offering me any financial discounts. So that was just prohibitive for me to pay at that time. So, luckily, I was able to access a grant in enough time to get the information I needed in order to assess whether I had an increased risk of developing ovarian cancer. And in my case, it turned out I did have a rare mutation, so it was lucky I was able to access the test when I did, but it did take over a year and a half for me, actively working on it like a part-time job. And I just knew that there were other women, who—definitely other women in Massachusetts with the same issues.


AMY GOODMAN: Sandra Park, you were a part of the team that argued this before the Supreme Court. The significance of this victory?


SANDRA PARK: It’s a huge victory. I think that what we had up to this point is a company that monopolized two human genes—genes that we all have in our bodies—and with that monopoly, dictated the terms of testing. So what you’ve heard from Lisbeth is they decide what the price was, with absolutely no competition. And they also decide which mutations that are looked for. They decide the quality of the test.


And what we now know is that there are many laboratories that are fully capable of offering this kind of testing, that would offer it in very different ways, so that they would be looking at the many genes that are connected with breast and ovarian cancer, and not just screening two. And so, with the ruling today, we fully expect much better access and much better options for patients, as well as for scientists who want to look at different parts of the genome. They no longer now need to deal with patents on the thousands of genes on our genome when they’re engaging in their scientific work.


JUAN GONZÁLEZ: And the direct impact immediately of this decision in terms of the availability of testing, not only for this, because this obviously has ramifications beyond these two particular genes, in terms of what’s going to happen in the industry?


SANDRA PARK: Right. Well, with these two genes, we’ve already heard two or three different laboratories have announced they plan to offer testing on the BRCA genes within the year. So it’s already had that immediate effect. But you’re absolutely right, the patent office has issued patents on thousands of human genes connected with diseases like muscular dystrophy, colon cancer. And so, what we expect to see is that patents on those genes will—are seriously under question with the ruling, and more options will become available.


AMY GOODMAN: I wanted to turn to Myriad Genetics’ lawyer, Gregory Castanias, tried to suggest patenting a gene is much like patenting a baseball bat. This is during oral arguments. He said a baseball bat doesn’t exist unless it’s isolated from a tree, but it’s still a product of human invention. Chief Justice Roberts took issue with the argument.


CHIEF JUSTICE JOHN ROBERTS: My understanding is that here what’s involved—obviously, through scientific processes, but we’re not talking about process—here what’s involved is snipping. You’ve got the thing there, and you snip—snip off the top, and you snip off the bottom, and there you’ve got it. The baseball bat is quite different. You don’t look at a tree and say, “Well, I’ll cut the branch here and cut it here, and all of a sudden I’ve got a baseball bat.” You have to invent it, if you will. You don’t have to invent the particular segment of the strand; you just have to cut it off.



AMY GOODMAN: During the hearing, Justice Sonia Sotomayor questioned Myriad Genetics’ lawyer. She compared patenting a gene to someone trying to patent the ingredients used to make chocolate chip cookies, such as sugar and flour.


JUSTICE SONIA SOTOMAYOR: I can bake a chocolate chip cookie using natural ingredients—salt, flour, eggs, butter. And I create my chocolate chip cookie. And if I combust those in some new way, I can get a patent on that. But I can’t imagine getting a patent simply on the basic items of salt, flour and eggs, simply because I’ve created a new use or a new product from those ingredients.



GREGORY CASTANIAS: And that’s—



JUSTICE SONIA SOTOMAYOR: Explain to me—



GREGORY CASTANIAS: Sure.



JUSTICE SONIA SOTOMAYOR: —why gene sequences, whether in the actual numbers, why gene sequences are not those basic products that you can’t patent.



GREGORY CASTANIAS: OK. I’ll start by showing you how this is actually a different structure. It actually has an entirely different chemical name when you give it the C—



JUSTICE SONIA SOTOMAYOR: That’s the cDNA.



GREGORY CASTANIAS: No, no, no. That’s absolutely true with regard—



JUSTICE SONIA SOTOMAYOR: Oh, only if your—



GREGORY CASTANIAS: —to the isolated molecule, as well, because if you were to write it out in those interminable chemical equations that you had to do in high school—



JUSTICE SONIA SOTOMAYOR: So, I put—



GREGORY CASTANIAS: —it’s a “C” very different, “H” very different.



JUSTICE SONIA SOTOMAYOR: I put salt in flour, and that’s different?



GREGORY CASTANIAS: Well, that is—



JUSTICE SONIA SOTOMAYOR: That’s—



GREGORY CASTANIAS: That is a combination, yes, of two different things. And that’s sort of like—that’s sort of like—



JUSTICE SONIA SOTOMAYOR: So if I take them apart, now you can get a patent on the salt, and now you can get a patent on the flour?



GREGORY CASTANIAS: Well, they were apart before, and they—but they were both old. That’s the problem with using the really simplistic analogies, with all due respect, Your Honor.



AMY GOODMAN: That was Justice Sonia Sotomayor questioning Myriad Genetics’ lawyer. Judge Sweet, your response on the significance of this ruling?


JUDGE ROBERT SWEET: Well, what the fundamental issue was—the issue was: Can you patent something that is a product of nature? Can you patent gold, and—for example? And what this decision has affirmed is that there are things in nature that cannot be patented. And one of those things in nature is your genome. It is a peculiar development that is natural. It is not the product of any outside influence. It is your genome, and that can’t be patented.


So the issue really is the extent to which your genome can be, if you will, grasped for some other purpose. And I think the court—I attended the argument. The justices were marvelously attentive. And I think the simple, direct and powerful nine-to-nothing decision indicates that they believe the genome is something that is important to be, if you will—not using it in a legal sense—but free. And it will make a difference, I believe, both in terms of availability for those who want the tests and also in terms of research. So, my view of it is that it is quite an—well, I know it’s an important and long-range decision. And—


AMY GOODMAN: Judge Robert Sweet, we’re going to have to leave it—we’re going to leave it there, and I thank you so much for being with us. Also, I know your clerks just got together and celebrated your 90th birthday. Happy birthday, Judge Robert Sweet. Also, thanks so much to Sandra Park and Lisbeth Ceriani.




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