65 MDs Declare Consensus Exists'
For Medicare to Widen NETT & Drop
Randomization for Certain Patients

A call has been issued to widen the National Emphysema Treatment Trial
(NETT) geographically and to drop randomization for certain patients
eligible for lung volume reduction surgery (LVRS).
The call was issued in a Consensus Statement on LVRS that was signed by
65 physicians from around the country, including
Dr. Joel Cooper, the re-inventor of the surgery.
The call declared that LVRS is a definite benefit to certain late-stage
emphysemics and Medicare should make it available to these patients
now. In effect the group statement asks Medicare to drop the
randomization of these patients, which is now part of the procedures,
or protocol, for the Medicare-financed 16-center research project
called National Emphysema Treatment Trial. The statement also said
Medicare-paid LVRS should be more geographically accessible--in other
words, make it more available to more medical centers, that are
qualified.
The call stated: "There is consensus within the medical community that
the available medical data regarding lung volume reduction surgery
support immediate Medicare coverage and payment for late stage
emphysema sufferers" who meet certain selection criteria.
Some of these criteria are:
·       Forced expiratory volume in one second less than 35% of predicted
·       Age: less than 75 years old (with exceptions based upon evaluation of
other criteria)
·       Ability to participate in vigorous pulmonary rehabilitation program
for eight continuous weeks prior to surgery
·       Emphysema with hyperinflation and defined target areas, e.g., areas
of poorly perfused, over-inflated lung, limited to the apices of the
lung.
The statement was signed by, among others, Dr. Thomas L. Petty. Most of
the signers listed are in thoracic surgery.

The statement is being distributed by a political activist group
started in July whose purpose is to change the NETT protocol. Printed
material distributed by the group states, "Our goal is to make the NETT
"patient friendly"~ by soliciting help from our elected
representatives..." The group is called the Coalition for Pulmonary
Patients Care. Their address is 12046 West 95th Street, #210, Lenexa,
KS 66215. Their E mail address is PulmonaryCoalition~Yahoo.com
A spokesperson for the new group, Linda Farris, said her husband had
gone through all the preparation for LVRS as part of the NETT program
but then became one of those who was "randomized out". (Part of the
Medicare-paid NETT program calls for half of the participants to have
the surgery, and half to not have the surgery, with the choice
completely random.) Her husband eventually chose to have the surgery
anyway, outside of the Medicare program, meaning they had to pay for
it.
She said the group welcomes others to join their effort. There is no
cost to join the Coalition, she said, but she does ask people who want
to join to supply the names of their Congressional representatives. The
Coalition aims many of its messages at Congress.

CORRECTION:
Mr. Farris was not enrolled in the NETT study program.  He decided his
best chance was to go as a self pay.