Look beyond the slogan, and other letters

Joe Carlson's interview with outgoing Federal Trade Commission Chairman Jon Leibowitz (“Championing consumers,”) repeated one of the chairman's favorite catchphrases, “pay-for-delay,” in the matter of patent settlements, but missed the point. As you might expect, there is more to the complex matter than a slogan, and that is why, over the past eight years, the courts repeatedly have said that it is the patent, not the settlement that keeps the generic off the market.

Some facts should not be overlooked:

The settlements are pro-competitive because they allow the generics to enter the market months and even years ahead of brand patent expirations. Not one patent settlement agreement has ever delayed the market entry of the generic drug past the expiration of the actual brand patent.

Patent settlements are transparent. Under federal law enacted in 2003, every patent settlement agreement is required to be submitted to the FTC and the Justice Department within 10 days of being reached. These two federal agencies have authority under that law to challenge those agreements they considered anti-competitive or anti-consumer.

Over the past decade, generic drug manufacturers have prevailed in only 48% of the nearly 400 drug patent litigation cases. This means that without settlements, consumers have less than a 50-50 chance of gaining access to the lower-cost generic medicines prior to brand patent expiration. But when a patent settlement is reached, consumers gain access to the lower-cost generic medicines prior to patent expiration 100% of the time.

When the whole story is told, readers will agree that patent settlements are pro-competitive and pro-consumer.

Ralph G. Neas

President and CEOGeneric Pharmaceutical AssociationWashington

There were a number of important points omitted in your look at the recent fiscal cliff deal (“A little extra in the fiscal cliff deal,”) that deserve to be clarified.

Most importantly, the healthcare provision at the center of the editorial is good public policy with bipartisan support. It will save Medicare and taxpayers $300 million over the next 10 years, according to the Congressional Budget Office.

The legislation equalizes brain radiosurgery reimbursement for treatments with similar patient outcomes and reversed an improper reimbursement change in 2007 that never should have been adopted in the first place.

This is precisely the kind of public policy that members of Congress should support and enact into law. A legislative solution was appropriate in this case because the CMS was prohibited by law from making this fix. This returns Varian and all other linear accelerator manufacturers to an equal footing with Elekta's cobalt technology.

Additionally, leading medical experts report similar results in brain radiosurgery whether it is performed using linear accelerators or cobalt technology. Each is commonly used for performing brain radiosurgery in a single session with a similar outcome. It makes sense then for each device to have an equal Medicare reimbursement.

Congressional action in this case to save Medicare millions, to create fair competition and level the playing field for American companies, and to correct an artificially inflated reimbursement rate at a time when all parties to the healthcare system are looking for ways to reduce costs, was not only the right policy, it was also the right thing to do.

Spencer Sias

Vice president of corporate communicationsVarian Medical SystemsPalo Alto, Calif.

Regarding your recent editorial, (“What's the matter with Texas?”), while there may be the perception that the American people voted for the Patient Protection and Affordable Care Act, the fact is that President Barack Obama was re-elected with less popular vote and Electoral College votes than in 2008.

That being said, Texas did not agree. Kudos to Gov. Rick Perry for understanding what the ACA will do to individual states and standing up against the force of the federal government.

H. Jay Banks

Principal and chief risk officerTexas International ConsultantsSeabrook, Texas

I've been a user of the VA software, starting with the FileManager and DHCP in the early 1980s, right up to the latest version of VistA and CPRS. I've supported its use in a large mental-health institution, a community hospital and in small clinics.

I have encountered the most bizarre antipathy toward VistA and MUMPS from supposed IT professionals who did not even know what they can do—it was not “modern” and not “object-oriented” and not “relational.” But as Joseph Conn said in his IT Everything blog (“The right and wrong decision,”), it is probably the best of the breed—the only one that can come near it is Epic, which costs a fortune and is closed to users so that they cannot customize to suit their needs.

Was I surprised to hear that the Defense Department wouldn't just adopt and adapt VistA? Good grief, no. How could they then spend more billions of our tax dollars on very profitable (for the commercial vendors) systems that would need to be scrapped and replaced (again profitably) within a short time? It just would not do.

I know most of those folks cited at the end of Joe's article, and I agree that if they were turned loose with some decent funding and support, VistA would emerge even better and stronger and the taxpayers would have gotten our money's worth.

Dr. Martin Mendelson

ChambesyGeneva, Switzerland