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BioWorld - Saturday, February 27, 2021
Home » Blogs » BioWorld MedTech Perspectives » A bipartisan breath of fresh air on the healthcare front

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BioWorld MedTech

A bipartisan breath of fresh air on the healthcare front

March 12, 2015
By Mark McCarty
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Skating champ Scott Hamilton sounds off on the device tax
Skating champ Scott Hamilton sounds off on the device tax

You don’t see it very much these days – bipartisanship. Yes, federal legislators on both sides of the political spectrum actually agree on something. This time they concur that the medical device tax, one of several funding mechanisms for the Affordable Care Act (ACA), has got to go. They argue that the tax stifles innovation and employment in the medical device industry.

Medical device companies will more likely pay this tax by withholding some investments in research and development and their workforce, rather than passing the cost onto their healthcare customers. Between research and development and employees, the likelier target for cuts is research and development, an area that is more of a delicate balancing act between risk and reward. Companies take a risk that their investment in better medical products will lead to a reward in the future, both for them and patients. It’s a leap of faith, it’s more speculative. There are no guarantees. But what is guaranteed is that according to ACA law, medical device vendors have to pay the medical device tax, and that money has to come from somewhere.

You may ask yourselves: Why would a retired Olympic figure skater care about how a tax impacts medical device companies? The answer is that I am the beneficiary of years of medical innovation, in this case a very specific medical procedure used to treat brain lesions – single-session Gamma Knife radiosurgery.

Several years ago, I was diagnosed with a benign brain tumor and received Gamma Knife radiosurgery. The therapy is incredibly precise and quick. From a semi-circular, helmet-like array around the head, the Gamma Knife focuses 201 beams of low-energy cobalt-60 radiation on the tumor target. When the beams converge on the lesion, the cumulative dose to the tumor is massive and highly conformal. In other words, the radiation dose is confined virtually exclusively to the tumor and not to healthy nearby brain tissue. For me, it meant I received a highly precise treatment without endangering my optic nerve. And I didn’t have to go back to the clinic on multiple occasions for additional treatments.

I’m intensely interested in this issue because Gamma Knife radiosurgery is truly an elegant and efficient procedure that can be used to treat many difficult brain tumor cases, both benign and malignant. It still amazes me that a single 30-minute procedure could have such a profoundly positive effect on my life.

My Gamma Knife radiosurgery experience

In 2004, I began suffering some unusual symptoms. I was listless and lacked the usual levels of energy that had propelled my career as a figure skater. In addition, I experienced some alarming blurriness in my vision and my testosterone levels were extremely low. MRI and positron emission tomography (PET) scans showed a 2.46 cm mass in my brain, the identity of which was subsequently confirmed by needle biopsy: I had a craniopharyngioma. This is a benign tumor that affects the pituitary gland in the brain.

Any kind of surgery to cut out this mass was out of the question, as part of the tumor was wrapped around the optic nerve of my right eye. Of course, doing nothing would have resulted in losing my vision in that eye over time.

I consulted an authority on craniopharyngiomas, and the physician told me that if I were his brother or son he would recommend Gamma Knife radiosurgery. Such an endorsement coming from an expert convinced me that Gamma Knife was the way to go. I had Gamma Knife radiosurgery on December 13, 2004. I had 26 “shots,” in which the 201 beams struck the craniopharyngioma from hundreds of different angles. Incredibly, the entire procedure took only 30 minutes, but that is not unusual for many different Gamma Knife cases. And just to reiterate, Gamma Knife radiosurgery is a single-session treatment – it was “one-and-done” – and the only side effect I had from the treatment was a two-Tylenol headache caused by fixation of the stereotactic frame to my head. By the time I went to bed and woke up next morning the headache was gone.

Every six months after radiosurgery I had brains scans, which showed that the tumor was diminishing in size until it became just a little dot and the lesion was no longer threatening my vision. And each time I went in, the results of the visual field tests would come back better and better, and hormone replacement therapy helped me regain the energy I had lost due to the impact of the lesion on my pituitary gland. In short, I was able to resume my life of speaking and authorship fairly quickly.

Fast forward to 2010, and unfortunately the craniopharyngioma had begun growing back, as these tumors often do. However, this time my physician informed me that the lesion was presenting beautifully for a minimally invasive transphenoidal surgical resection that would not endanger my optic nerve. After that operation, the tumor was gone for good.

A vote for more R&D

The epilogue of this story is that in 2004 I was able to take advantage of a truly remarkable single-session therapy that was the only practical option available to me. But Gamma Knife radiosurgery wasn’t developed overnight – it took decades of continuous refinement and millions of invested R&D dollars by its manufacturer (Elekta) to arrive at the level of technology that is capable of delivering such miracles.

Reflecting on my experience I always wonder what new medicines or techniques are now in peril of never seeing the light of day because companies have had to cut back on research and development. Maybe it’s development of a new cancer drug or a more effective pacemaker. It could even be the next generation Gamma Knife system that could be used to benefit untold thousands of additional patients worldwide.

I join with the hundreds of American medical device manufacturers in supporting a repeal of the medical device tax, and call on Congress and President Obama to join this effort. Continuous innovation in medical technology depends on it.

Scott Hamilton is a retired American figure skater, Olympic gold medalist, speaker and author. He won four consecutive U.S. championships, four consecutive World Championships and a gold medal in the 1984 Olympics.

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