WASHINGTON _ Just hours before the final Democratic leadershipbill was scheduled to make its debut on the House floor Wednesday,the biotechnology industry snatched victory from the jaws of defeat.After a meeting with pro-biotechnology House members, MajorityLeader Richard Gephardt (D-Mo.) verbally agreed to delete aprescription drug payment review commission from his bill and tomake changes that could exempt biotechnology drugs administered bya physician from rebate requirements under Medicare.Gephardt's promised changes have not yet appeared in print andWashington insiders warned that the final legislative language will becritical.Gephardt said on Wednesday that the changes will "make the Househealth care reform bill even stronger by ensuring that thebiotechnology industry can continue to make great strides in medicalresearch." And he singled out Rep. Lynn Schenk (D-Calif.) for praise:"By working so hard to reflect the concerns of the biotechnologyindustry, Congresswoman Schenk has helped make this bill even moreeffective and responsive to the American people.""In crafting a bill of this scope and significance, we depend upon thecollaboration of every member of the House; ultimately that's the onlyway we can ensure that we produce legislation that meets the needs andconcerns of all Americans," he said.Gephardt apparently bowed to the cumulative pressure of letters fromand meetings with a well-organized contingent of House members ledby Schenk, and by Anna Eshoo (D-Calif.) and Joe Kennedy (D-Mass.).In exchange for making the changes, Gephardt won their support aswell as that of others who have argued that the commission and rebaterequirements could damage the biotechnology industry."I am gratified that the Majority Leader has been responsive to theneed to seek protections for the biotech industry's ability to seek curesfor major diseases," said Schenk. "Biotech research requires significantcapital investment, but that investment can lead to ultimate reductionsin health care costs for all Americans.""Developing biotech products are high-risk, long-term ventures," saidKennedy. "This will ensure that biotech companies can get areasonable return on their risk."Gephardt announced the changes in the leadership bill after anafternoon meeting with about 11 House members. The meeting wasrequested by Schenk in a private meeting with Gephardt on Tuesdaynight, according to a Schenk spokeswoman. Eshoo issued a statementimmediately after the meeting declaring that Gephardt's bill was avictory for the biotechnology industry."The biotechnology industry is comprised of small, start-up firms thatare the wave of the future for jobs in the Silicon Valley [Eshoorepresents the 14th district in California which is home to SiliconValley]," she said. "Only 1 percent of these firms have any products onthe market, so they rely on venture capital to stay in business, andanything which has an impact on these investments can influence theirfinancial situation. These small businesses truly need the type ofassistance which Rep. Gephardt has given them."The blueprint for Gephardt's legislation was a bill reported by theHouse Ways and Means Committee that included a prescription drugprice review commission. In addition, it transferred coverage of drugsadministered by a physician from the Medicare Part B benefit programto a new Medicare outpatient drug benefit program that would requiremanufacturers to pay a 15 percent rebate to the government.Gephardt verbally promised on Wednesday to replace the price reviewcommission with a "Medical Technology Impact Study." The newstudy would be similar to a Senate proposal that requires the Agencyfor Health Care Policy and Research (AHCPR) to conduct cost-effectiveness studies of new and existing medical technologies.Instead of focusing only on the prices of drugs (as the payment reviewcommission was designed to do), the AHCPR study would compareand analyze the overall economic costs, benefits and patient outcomesof all medical technologies used to treat diseases and conditions.The AHCPR proposal originated in talks between Genzyme Corp. andSen. Edward Kennedy (D-Mass.), chairman of the Senate Labor andHuman Resources Committee. Kennedy deleted a breakthrough drugcommittee from his committee's health care bill and replaced it withthe AHCPR study. The AHCPR study was included in the health carebill introduced by Senate Majority Leader George Mitchell (D-Maine)last week."With this new initiative, the House majority leader has taken asignificant step in producing health care legislation which willencourage medical innovation," said Biotechnology IndustryOrganization president Carl Feldbaum. "The Senate can achieve thesame goal by adopting similar language."AARP Endorses Mitchell, Gephardt BillsThe 33 million-member American Association of Retired Persons(AARP) endorsed the Democratic leadership bills pending in bothchambers of Congress on Wednesday and warned that if either bill isdefeated, health care reform "will be dead for years to come."AARP president Eugene Lehrmann said that the benefits of provisionsin both bills to cover outpatient prescription drugs and long-term careunder Medicare outweighed proposed cuts in Medicare and increasedtaxes for wealthy Medicare recipients. He said that the AARP plans torun newspaper ads and to mobilize its 250,000 volunteers to lobby forthe bills."Although neither bill is perfect, after careful review we conclude thatthey provide the foundation for comprehensive health care for allAmericans," said Lehrmann at a press conference. He pointed out thatthe group abstained from endorsing any specific proposal until now. n081294

-- Lisa Piercey Washington Editor

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