(Circulation. 2000;101:e9054.)
© 2000 American Heart Association, Inc.
Cardiovascular News |
Cardiovascular News
Jan L. Breslow, MD, Receives 10th Annual Bristol-Myers Squibb Award
Jan L. Breslow, MD, is the 10th recipient of the annual Bristol-Myers Squibb Award for Distinguished Achievement in Cardiovascular Research for his pioneering work on apolipoproteins and the genetic variations of one of these, apoE. His seminal work provided a foundation for understanding how the variations in apoE can affect individual susceptibility to Alzheimer’s disease, coronary heart disease, and aging.
Dr Breslow, who is the head of the Laboratory of Biochemical Genetics and Metabolism at Rockefeller University, focused his work on the genetic factors that control an individual’s susceptibility to atherosclerosis. He was the first scientist to use recombinant DNA technology to study atherosclerosis. His work revealed that certain genes can predispose a person to the problem or can protect against developing it—even when environmental factors such as diet, exercise, and smoking are taken into account.
He and colleagues in his laboratory developed a "knockout" mouse that lacked a gene for apoE, thus providing the first small animal model of atherosclerosis. Experiments with this animal showed that a single genetic alteration was sufficient to convert a mouse resistant to atherosclerosis into a mouse that developed the disease. This mouse is now a major experimental model for studying the disease.
Richard Gregg, MD, vice president for metabolic and cardiovascular drug discovery with the Bristol-Myers Squibb Pharmaceutical Research Institute, noted that Dr Breslow "appreciated very early on the potential of molecular biology and transgenic approaches, and his development of the homozygous apoE deficient mouse was a milestone in understanding the causes of atherosclerosis. We are very proud to honor him with this award."
Dr Breslow is currently using genomic technology to find new genes associated with susceptibility to atherosclerosis—both in a genetically isolated human population and in apoE knockout mice in which the knockout trait has been bred into different inbred mouse backgrounds. He and his colleagues are also investigating the hereditary and environmental factors associated with the development of atherosclerosis.
A past president of the American Heart Association, Dr Breslow has also served as vice president of the American Society for Clinical Investigation and as chairman of the research committees of both the American Heart Association National Center and the New York Affiliate. He was elected to membership in the National Academy of Sciences in 1995, the Deutsche Akademie der Naturforscher Leopoldina in 1996, and the Institute of Medicine in 1997. Dr Breslow received his AB and MA degrees from Columbia University and his MD from Harvard Medical School. He completed an internship and a pediatrics residency at Children’s Hospital Medical Center in Boston and a 3-year fellowship at the National Health and Lung Institute. After a stint at Harvard and Children’s Hospital, he joined Rockefeller University in 1984 and was appointed the Frederick Henry Leonhardt Professor.
He received the Bristol-Myers Squibb Award in New York City on May 10, 2000. The award consists of a silver medallion and a $50 000 cash prize.
Shalala Seeks to Lower Reimbursement Rates for Medicare- and Medicaid-Covered Drugs
Health and Human Services Secretary Donna Shalala informed federal lawmakers on June 2, 2000, that she was encouraging companies that process Medicare claims to lower reimbursement rates for drugs covered by Medicare and Medicaid. The lower rates would be based on the findings of an ongoing investigation into the pharmaceutical industry.
"We are now moving administratively to take advantage of the newly available, more accurate data on average wholesale prices developed for Medicaid as a result of Department of Justice investigations," she wrote in her letters to concerned lawmakers. The Associated Press reported that one of the letters went to Thomas Bliley (R-Va), chairman of the House Commerce Committee. Mr Bliley had informed both Secretary Shalala and the heads of drug companies of his concerns about the high prices that government programs seemed to be paying for drugs.
President Clinton has made adding the coverage of prescription drugs to Medicare a major thrust of the waning days of his presidency, and some legislators—including Representative Pete Stark (D-Calif)—saw the move by Shalala as an attempt to begin that dialogue with the industry.
In the past, both Medicare and Medicaid based their reimbursement rates for drugs on industry guidebooks. However, federal investigators have claimed that those prices are higher than what doctors and pharmacies pay. The inspector general of the Department of Health and Human Services has estimated that Medicare pays as much as 900% more for drugs than do doctors or pharmacies.
American Medical Association Irked by Late-Night Tabling of Bill That Would Allow Negotiation With Managed Care Companies
Leaders of the American Medical Association (AMA) expressed outrage May 25, 2000, after the US House Rules Committee, in a late-night session, voted to delay a scheduled vote on a bill that would have given physicians the right to band together in professional associations to bargain with managed care companies. "It is hard to imagine a more outrageous subversion of the American democratic process," said D. Ted Lewers, MD, chair of the AMA board of trustees, in a released statement. "How can a Rules Committee—selected by the Speaker of the House—pull a bill from floor consideration that has the support of more than a majority of the House of Representatives?"
The bill (HR 1304) was introduced by Tom Campbell (R-Calif), and he had reported that House Speaker Dennis Hastert (R-Ill) had promised to bring the bill before the full house in the last week of May. "The American concept of fair play demands that vital issues get a fair hearing," said Dr Lewers. "But the Rules Committee ignored that process and turned its back on the patients and physicians of America."
He said the provisions of the Campbell bill would allow physicians to act as advocates for patients and themselves. Physicians could negotiate with managed care companies over contract provisions that would stand in the way of good patient care. "Insurers have had almost unlimited power over health care for far too long, and they have chosen profits over patients each and every time," noted Dr Lewers.
Rep Campbell said, "It would be an understatement to say that yesterday was a disappointment for myself and my colleagues who care passionately about this issue. However, it would be wrong to assume that any of us have given up this fight." He noted that Speaker Hastert has repeatedly promised to bring the bill before the full House only to pull it back at the last minute. "I understand that the burdens of being the Speaker of the House are immense. And I entirely recognize that no one bill—let alone this one—must compel the full attention of the Speaker... What happened yesterday was outrageous, and it causes many Americans to grow disenchanted with our political system." However, Campbell remains hopeful that the bill will reach the House floor at some time during this session.
The AMA maintains that the bill giving physicians the right to bargain collectively is the only way the profession can even the tug-of-war between it and managed care companies. However, not surprisingly, insurers are adamantly opposed to the measure. The disagreement has resulted in a war of words and terminology.
Karen Ignagni, president and chief executive officer of the American Association of Health Plans, called the proposal a plan for a "cartel" of physicians. "For those questioning why the vote on the Campbell cartel bill was delayed, they need look no further than at the substance of the legislation," she said in a released statement. "The substance of the bill—and its inherent anti-consumer approach—is what’s driving Congress to take a fresh look... The Campbell bill puts the personal financial interests of a vocal minority ahead of working families, seniors, and small businesses. The Campbell physician cartel bill is the most anti-consumer piece of legislation seen on Capitol Hill in decades. We applaud Congress for taking more time to examine the full consequences of the bill and what it would mean for health care consumers."
Ignani’s group is the largest national trade organization representing health maintenance organizations (HMOs) and preferred provider organizations (PPOs).
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