Critical Juncture for Health Care Reform

Urge your U.S. Senators to Support Health Care Reform



We are at a critical juncture in the effort to overhaul and improve our nation's health care system. MS activists played an important role in shaping the process, from release of the Society's National Health Care Reform Principles to relentlessly making calls and sending emails to ensure that the legislation adequately supports those living with MS. As the Senate completes work on its health reform package, MS activists must rise to the occasion one more time. The Senate could vote as early as tomorrow, so contact your Senators now and urge them to support the Senate health reform bill.

The Senate bill makes substantial investments that will improve the lives of people living with MS and other chronic conditions or disabilities. In line with the Society's Principles, the Senate bill:

* Extends health coverage to tens of millions of people who are currently uninsured and underinsured;
* Works towards eliminating pre-existing condition discrimination;
* Prohibits monetary lifetime benefit caps;
* Restricts the use of annual limits to ensure access to needed care and beginning in 2014, completely prohibits monetary annual limits;
* Helps make coverage affordable by limiting out-of-pocket costs, providing subsidies to lower-income families;
* Increases certain providers' reimbursement; and
* Invests in community-based and long-term care.

People living with MS and other chronic conditions are particularly vulnerable in our current health care system. We need meaningful reform now.
Every vote counts. Take action today and urge both of your Senators to support the health reform bill so that we can seize this historic opportunity and take a true step towards accessible, affordable, comprehensive, quality health care for all.

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Nov 12, 2009 New Data Support Early Interferon Treatment for Multiple Sclerosis

In a study of 2,570 people with MS, early treatment with interferon therapy was associated with a significant reduction in the risk of MS progression. Maria Trojano, MD (University of Bari, Italy) and colleagues from 14 other Italian centers report their findings in Annals of Neurology. (2009;66(4):513-520)
Background: Currently six therapies are approved by the U.S. Food and Drug Administration for the treatment of MS. These agents can reduce future disease activity for many individuals with relapsing forms of MS, including those with secondary progressive disease who continue to have relapses. The National MS Society’s Medical Advisory Board recommends that initiating MS therapy with an immunomodulating drug (such as FDA-approved interferons or glatiramer acetate) should be considered as soon as possible following a definite diagnosis of MS with a relapsing course, and for selected patients with a first attack who are at high risk for MS. Some clinicians disagree, however, choosing to defer treatment until the extent of disease activity is more clearly established.
The Study: Dr. Trojano and colleagues at 15 Italian MS centers followed a group of 2,570 people with relapsing-remitting MS who were being treated with any type of interferon beta for up to seven years. Treatments included one of two dosing regimens of Rebif® (interferon beta-1a, EMD Serono, Inc. and Pfizer, Inc.), Avonex® (interferon beta-1a, Biogen Idec), and Betaferon® (European brand of Betaseron, interferon beta-1b, Bayer Schering Pharma AG).
The investigators recorded the dates of MS onset and treatment, and tracked disease progression every six months using the EDSS scale, which measures physical disability on a rating scale of 0 to 10. Early treatment was defined as less than or equal to one year from disease onset, and delayed treatment was defined as more than one year from MS onset.
After following individuals for a median of 4.5 years, and using statistical methods aimed at adjusting for potential biases, the investigators found that early treatment significantly reduced the risk of progressing one point on the EDSS scale compared to those whose treatment was delayed. Early treatment also reduced, by about 40%, the risk of progressing to an EDSS score of 4. (An EDSS score of 4 is defined as fully ambulatory and self-sufficient, despite severe disability in one system, such as visual or sensory systems, or less severe disability in a combination of systems). The interferons were not rated separately, so it is not known if one worked better than another.
Comment: “This large-scale study adds significant support to considering MS treatment as soon as possible following a diagnosis of probable or definite MS,” commented John R. Richert, MD, who heads research and clinical programs at the National MS Society.
There are many strategies available to modify the disease course, treat relapses, manage symptoms, and improve function and quality of life for people who have MS. Determining the best treatment options is a complex decision best made in collaboration between the person with MS and his or her neurologist. Read more about treatment options and the information and support available for people who are newly diagnosed with MS.
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Multiple sclerosis 'blood blockage theory' tested

By Michelle Roberts
Health reporter,
BBC News

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US scientists are testing a radical new theory that multiple sclerosis (MS) is caused by blockages in the veins that drain the brain.

The University of Buffalo team were intrigued by the work of Italian researcher Dr Paolo Zamboni who claims 90% of MS is caused by narrowed veins.

He says the restricted drainage, visible on scans, injures the brain leading to MS.

He has already widened the blockages in a handful of patients.

The US team want to replicate his earlier work before treating patients.

Experts welcomed the research saying it was important to confirm the basic science before evaluating any therapy.

MS is a long-term inflammatory condition of the central nervous system which affects the transfer of messages from the nervous system to the rest of the body.

This is not something patients can expect as a treatment now. This is experimental work and is being tested
A spokeswoman for the MS Society

The Buffalo team, led by Dr Robert Zivadinov, plan to recruit 1,100 patients with MS and 600 other volunteers as controls who are either healthy or have neurological diseases other than MS.

Using Doppler ultrasound, they will scan the patients to see if they can find any blockages within the veins of the neck and brain.

If they can prove Dr Zamboni's theory of "chronic cerebrospinal venous insufficiency", they say it will change our understanding of MS.

Rewriting science

Margaret Paroski, who is chief medical officer at Kaleida Health, where the Buffalo researchers are based, said the work could overturn prevailing wisdom that the damage in MS is predominantly the result of abnormal immune responses.

"When I was in medical school, we thought peptic ulcer disease was due to stress. We now know that 80% of cases are due to a bacterial infection.

I found the evidence of narrowing - narrowing of the veins just in MS patients
Dr Zamboni

"Dr Zivadinov's work may lead to a whole different way of thinking about MS."

Dr Zamboni, of the University of Ferrara, believes the blockages are the cause rather than the consequence of MS and that they allow iron from the blood to leak into the brain tissue, where it causes damage.

He has performed procedures similar to angioplasty to unblock the veins and get the blood flowing normally again.

He claims this "liberation procedure" can alleviate many of the symptoms of MS and is due to publish his findings in the Journal of Vascular Surgery.

In an interview with CTV News in Canada he said: "I found the evidence of narrowing - narrowing of the veins just in MS patients.

"I'm fully convinced that this is very, very important for people."

Early days

Kevin Lipp, an MS patient from the US, has been symptom-free since being treated by Dr Zamboni.

He said: "It's only been 10 months. If nothing happens in the next two to three years, we'll know it's working."

The BBC has heard anecdotally of other surgeons in Europe testing out the same treatment.

The MS Society said more research was needed to see if this was an avenue that should be explored further.

"This is not something patients can expect as a treatment now. This is experimental work and is being tested. We need to know more about its safety and effectiveness."

Helen Yates, of the MS Resource Centre, said: "There is no doubt that this area warrants a great deal more study.

"This could represent a completely novel approach to MS research which, if proven to be relevant, could be a "sea change" in the understanding of the mechanisms involved in the condition."

National Multiple Sclerosis Society

Issue Briefs and Background

National MS Society Homepage




Call Now to Support Neurologists in Health Reform

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MS activists must continue to shape the health care reform debate. The U.S. Senate is completing work on its comprehensive health reform bill, The Patient Protection and Affordable Care Act (H.R. 3590). The bill includes many provisions that will help people with MS, but unfortunately leaves out important support for neurologists who are critical to effectively diagnosing and treating MS.

Senator Amy Klobuchar (MN) has introduced an amendment with bipartisan support that would make neurologists eligible for a 10% Medicare payment incentive, to expand and ensure access to services needed by those with MS and other neurological conditions. As currently written, the Senate health reform bill would only provide incentive to family practitioners and those engaged in internal geriatric, or pediatric medicine.

Please take a minute to call both of your U.S. Senators and ask each to support Senator Klobuchar's neurology amendment. We are further than we ever have been before to seeing true progress in achieving accessible, affordable health coverage for all. Supporting neurologists is in line with the Society's National Health Care Reform Principles to provide unfettered access to appropriate medical providers and specialists and to offer appropriate and increased provider reimbursement rates to reflect the complex care required to treat those with MS and chronic illnesses.

Contact the Capitol Switchboard at 1-800-828-0498 and ask to speak with each of your U.S. Senators. Tell each of your Senators to support Senator Klobuchar's bipartisan neurology amendment to the Senate health reform bill, H.R. 3590.

Talking Points:

* I am a constituent and urge the Senator to support Senator Klobuchar's bipartisan neurology amendment to the Senate health reform bill, H.R. 3590.
* This amendment would make neurologists eligible for primary care incentives. As the bill is currently written, neurologists are the only physicians who regularly manage and coordinate care who cannot receive the incentive.
* Trained in diseases of the central nervous system, neurologists are often the best qualified physicians to diagnose and treat people with MS. There is no cure for MS, making neurologists' intervention critical to helping people with MS modify the disease course, treat relapses, manage symptoms, and improve function.
* Meaningful access to expert care offered by neurologists is imperative not only to people with MS, but also those with other neurological diseases such as Parkinson's and Alzheimer's.