Insurance

MEMPHIS, Tenn., May 3 /PRNewswire-FirstCall/ -- Recent new data(1) presented at this year's American Academy of Orthopaedic Surgeons (AAOS) annual meeting reinforces the BIRMINGHAM HIP™ Resurfacing (BHR) System as a safe and effective hip resurfacing device. The multi-site study, performed by orthopedic surgeons practicing at nine Canadian academic centers, showed that three years after surgery, 99.91% of their 3,400 hip resurfacing patients experienced no implant failure due to metal wear debris. The BHR Hip was the most used resurfacing device in this study.

This week, the Hospital for Special Surgery (HSS) in New York City will be holding a medical education course titled "Total Hip: Replacement and Resurfacing" on May 7 and 8 for leading hip surgery specialists from across the U.S. Chairing the course will be Edwin Su, MD, of the Hospital for Special Surgery, and the teaching faculty will include pioneering British surgeon Derek McMinn, MD, inventor of the BHR hip.

During a press conference and Q&A webcast on Thursday, May 6, at 3 p.m. US EDT, 8 p.m. GMT, Joseph M. DeVivo, president of Smith & Nephew Orthopaedics (NYSE: SNN, LSE: SN), the maker of the BHR Hip, will be joined by Dr. Su and Mr. McMinn, as well as Scott Marwin, MD, an orthopedic surgeon with New York University's Hospital for Joint Diseases. The panel will review current data confirming the safety and effectiveness of hip resurfacing and the BHR Hip. Smith & Nephew Orthopaedics will host the call, and additional details are at the bottom of this release.

The new study recently presented at the AAOS meeting aligns with previously released BHR Hip data from other prestigious sources and further addresses the metal wear debris concerns raised about metal-on-metal hip implants.  The BHR Hip's track record for longevity remains unchallenged in the literature, as well. These sources include:

• The Journal of Bone and Joint Surgery published in January of this year a study tracking 155 consecutive BHR patients over three years. The data showed no revisions of BHR Hips due to metal wear, but patients who received a competing metal-on-metal resurfacing device were revised within three years of surgery at a rate of 3.4-percent due to adverse tissue reactions.(2)
• The Australian Orthopaedic Association's 2008 National Joint Replacement Registry, a record of nearly every hip implanted in that country over the previous 10 years, tracked 6,773 BHR Hips and found that less than one-third of one-percent may have been revised due to the patient's reaction to the metal component.(3)  
• The Australian Registry hip resurfacing data for 2009, 70-percent of which comes from BHR Hip procedures, indicates that for men under age 65, hip resurfacing performs at the same or a better rate than total hip replacement. This registry also shows that the BHR Hip remains successful in 95-percent of cases eight years after surgery, whereas no other implant performs better than 94.7-percent just five years after surgery.(4)
• Great Britain's Oswestry Outcomes Centre's patient registry,  which tracked 5,000 BHR Hips implanted by 148 different surgeons in 37 countries over 10 years (1998-2008), reports that the BHR Hip remains successful in 95.4-percent of all patient segments 10 years after surgery. This registry also reported that 98.6-percent of patients were "pleased" or "extremely satisfied" with their BHR Hip implants 10 years after their resurfacing procedure.(5)
• Mr. McMinn's clinical data, based on 3,095 hip resurfacing patients implanted between 1997 and 2009, shows that more than 12 years after surgery, the BHR hip remains successful in 99-percent of men aged 60 and over, and 97-percent for men under age 60.

"The BHR Hip's outcomes are remarkable when compared to other resurfacing devices," said Dr. Marwin. "The depth and consistency of the data collected globally shows the BHR Hip is truly different."

"For the right patients in my practice, hip resurfacing has proven to be an excellent choice," said Dr. Su. "They have extremely high levels of satisfaction after returning to their regular lifestyle."

To explain the patient advantages seen consistently in the literature, surgeons indicate the key differences between the BHR Hip and other resurfacing devices are its metal composition, its design geometry and its surgical instrumentation.

The BHR Hip has a unique metallurgy heritage which goes back more than 30 years and includes a first-generation metal-on-metal resurfacing process which contributes to long-term survivorship of BHR Hip recipients.

Additionally, the BHR Hip's design geometry replicates the natural hip's ability to pull the body's own joint fluids into the ball and socket interface, which is believed to be another source of its best-in-class performance.

Of particular importance during hip resurfacing surgery is the correct positioning of the acetabular cup, or hip socket. When this component is not properly aligned, studies show that metal wear can accelerate and resurfacing devices can fail before their time.  Surgeons believe that the instrument used to implant the BHR Hip is simpler and more accurate than other devices' instruments, and may contribute to its success.

"Just like the lubricating barrier in a healthy hip, there is a natural fluid layer between the femoral head and the cup that the two metal surfaces glide across during physical activity," said Mr. McMinn. "If the surgeon malpositions the acetabular cup causing edge loading, the lubrication is lost. It's equivalent to running a car engine without lubrication oil. High wear will occur, resulting in premature failure. Overall, it is a combination of the metal composition, the design and the quality of the surgical technique that makes the BHR Hip the safest resurfacing implant on the market."

"The bottom line is that the BHR Hip is not like other metal-on-metal hip implants," said DeVivo. "Not only does it have the longest track record of any resurfacing device, but the most esteemed medical literature shows it outlasts other implants. It's in a class all its own – it's safe and effective, and is the best choice for active patients."



Footnotes

(1) Beaule PE, Smith FC, Powell JN et al. A Survey on the Incidence of Pseudotumours with MOM Hip Resurfacings in Canadian Academic Centres. Podium presentation # 665. Proceedings of the American Academy of Orthopaedic Surgeons Annual Meeting, New Orleans LA. 2010

(2) Langton DJ, Jameson SS, Joyce TJ, Hallab NJ, Natu S, Nargol AVF.  Early failure of metal-on-metal bearings in hip resurfacing and large-diameter total hip replacement, A CONSEQUENCE OF EXCESS WEAR. J Bone Joint Surg Br. 2010; 92-B: 38-46

(3) Table HT 46. Australian Orthopaedic Association National Joint Replacement Registry Annual Report. Adelaide: AOA; 2008.

(4) Table HT 46. Australian Orthopaedic Association National Joint Replacement Registry Annual Report. Adelaide: AOA; 2009.

(5) Robinson E, Richardson JB, Khan M. MINIMUM 10 YEAR OUTCOME OF BIRMINGHAM HIP RESURFACING (BHR), A REVIEW OF 518 CASES FROM AN INTERNATIONAL REGISTER. Oswestry outcome centre, Oswestry, UK.

About Us

Smith & Nephew is a global medical technology business, specialising in Orthopaedics, including Reconstruction, Trauma and Clinical Therapies; Endoscopy and Advanced Wound Management.  Smith & Nephew is a global leader in arthroscopy and advanced wound management and is one of the leading global orthopaedics companies.

Smith & Nephew is dedicated to helping improve people's lives.  The Company prides itself on the strength of its relationships with its surgeons and professional healthcare customers, with whom its name is synonymous with high standards of performance, innovation and trust.  The Company operates in 32 countries around the world.  Annual sales in 2009 were nearly $3.8 billion.

Forward-Looking Statements

This press release contains certain "forward-looking statements" within the meaning of the US Private Securities Litigation Reform Act of 1995.  In particular, statements regarding expected revenue growth and trading margins discussed under "Outlook" are forward-looking statements as are discussions of our product pipeline.  These statements, as well as the phrases "aim", "plan", "intend", "anticipate", "well-placed", "believe", "estimate", "expect", "target", "consider" and similar expressions, are generally intended to identify forward-looking statements.  Such forward-looking statements involve known and unknown risks, uncertainties and other important factors (including, but not limited to, the outcome of litigation, claims and regulatory approvals) that could cause the actual results, performance or achievements of Smith & Nephew, or industry results, to differ materially from any future results, performance or achievements expressed or implied by such forward-looking statements.  Please refer to the documents that Smith & Nephew has filed with the U.S. Securities and Exchange Commission under the U.S. Securities Exchange Act of 1934, as amended, including Smith & Nephew's most recent annual report on Form 20F, for a discussion of certain of these factors.

All forward-looking statements in this press release are based on information available to Smith & Nephew as of the date hereof.  All written or oral forward-looking statements attributable to Smith & Nephew or any person acting on behalf of Smith & Nephew are expressly qualified in their entirety by the foregoing.  Smith & Nephew does not undertake any obligation to update or revise any forward-looking statement contained herein to reflect any change in Smith & Nephew's expectation with regard thereto or any change in events, conditions or circumstances on which any such statement is based.

Trademark of Smith & Nephew.  Certain marks registered US Patent and Trademark Office.

Medicare is going to decide if it should start discussions about covering Hip Resurfacing soon.  I am explaining this in layman's terms.  There are long processes that government goes through with technical terms, but basically the public is invited to comment on what procedures will be discussed for approval.

This is a chance for all hip resurfacing patients and potential patients to make comments to Medicare. I have been told that Medicare listens to surgeons, patients, patient advocates and the general public.  This is an opportunity for hip resurfacing to be covered by Medicare.  I have also been told that Medicare is the benchmark for most insurance companies.  If Medicare covers a procedure, then normally most insurance companies will also cover the same procedure.

If you have had a hip resurfacing and would like to encourage Medicare to cover Hip Resurfacing, please take time to comment.  If you need a hip resurfacing and would like to encourage Medicare to cover Hip Resurfacing, please take time to comment.

According to the Yahoo Surface Hippy Survey of 855 patients, 460 patients were in the 50 – 69 year old category.

http://www.surfacehippy.info/survey/hipresurfacingsurvey.php

That means most patients that had one hip resurfacing will probably need another in the future.  If you will be 65 when you need your hip resurfacing, I am sure you will want Medicare to cover the surgery.  You don't want to travel overseas like many of us had to.

I think Surface Hippies can make a difference if we all take a few minutes to comment to Medicare.

I have prepared two letters that you can copy and paste if you don't want to write one yourself. They are posted on the Surface Hippy Website. If you visit the home page of the Surface Hippy Website you can find more information and the sample letters

http://www.surfacehippy.info

The the url to the Comment Page on the Medicare Website is listed below:

Click Here to Visit Medicare Comment Page

Please take a few minutes to post a comment.

We can make a difference and this is our chance to be heard.

The closing date for comments is September 28, 2008.

Link  - Read Complete Story by Clicking Here

August 12, 2008

The debate over U.S. health-care reform rages on. But why wait for someone else to dictate your future? You have many options -- if you're willing to take a vacation. If recovering from a medical procedure while lying on a palm-swept beach, relaxing by the hotel pool, or shopping for terrific bargains sounds good, then medical vacations may be exactly the right solution for you.

From hip replacement to heart surgery, more people are discovering the advantages of traveling abroad for their medical needs.

A big growth industry
In just the past few years, medical vacations have gone from a tiny niche market to an impressive growth story with substantial market-share gains. From Mexico to India, Costa Rica to Thailand, hospitals are taking advantage of this global trend. And U.S. companies are taking note as well. Aetna (NYSE: AET) and Blue Cross Blue Shield of South Carolina are among the health-care companies tailoring their corporate health insurance plans to give employees the opportunity to head to India or elsewhere for surgeries such as knee replacements and the more modern, less invasive approach to hip replacement, hip resurfacing...

Read More

June 2008

Link http://www.nbc11.com/msnbchealth/16748813/detail.html

Timmi Ryerson, a San Diego stock market analyst, says her left hip actually works again, thanks to an orthopedic specialist in India.

...What's new about these procedures is not the exotic locales the three chose, but the way they paid for their far-flung surgeries.

While at least 150,000 Americans travel abroad for medical care every year, according to the American Medical Association, Ryerson, Mason and Davies represent a small but growing category of medical tourist: patients whose insurance companies have agreed to foot at least part of the bill.

"I think that's the solution to our health care crisis," said Davies, 53, whose company plan, Delta Dental, maxed out his dental benefit, about $2,500, toward the $30,000 he spent to repair damage caused by years of grinding his teeth, a procedure that would have cost an estimated $80,000 in the United States.

Increasingly, some of the nation's larger employers and leading health insurers agree.

Once the province of the poor and uninsured, medical tourism is gaining attention of industry giants such as CIGNA, Aetna and Blue Cross/Blue Shield, who say they either have begun or are considering pilot programs that provide limited coverage for foreign care. One Montana firm, Employee Benefit Management Services Inc., recently began offering medial tourism plans to its 120 self-insured clients in the Northwest...
 

"I just think that others need to be aware that they are able to have a safe procedure done out of the country for a price at a third the cost," she said.

Ryerson, 61, said her private Blue Cross plan paid 80 percent of a $7,000 hip resurfacing surgery in Chennai, India, that would have been about $55,000 in the U.S. - if she could get it at all.

In 2006, the hip resurfacing device necessary for her surgery had just been approved for U.S. use by the federal Food and Drug Administration and not many domestic doctors had experience with it. Dr. Vijay Bose, her U.K.-certified surgeon in India, had performed the surgery more than 1,100 times.

"Doctors here didn't know what they didn't know and I didn't want to be a guinea pig," she said.

While she was there, Ryerson also had cosmetic surgery and dental work done at her own expense...
 

Need health insurance? Better get to work
Do research to find the best individual plan

Link  http://www.kentucky.com/147/story/279530.html

By Jane Glenn Haas
THE ORANGE COUNTY REGISTER
If you are too young for Medicare but considering leaving a job that offers group health insurance, it pays to do some research.

After a yearlong investigation, Consumer Reports has concluded that 89 percent of the people younger than 65 who look for individual health insurance do not buy it because it is too costly, because they are turned down for health reasons or because benefits are inadequate.

"Private insurance is virtually out of the question for 76 percent of uninsured Americans -- and those who do have insurance told us wrenching stories about the high costs and poor coverage they receive," says Nancy Metcalf, health editor at Consumer Reports.

She calls searching for private insurance "daunting" and a challenge to any adult who hopes to retire early, loses a job, is self-employed or has an adult child leaving a group plan.

"The nature of health insurance is that the only people profitably to insure are those who are healthy," Metcalf says.

Question: Why can a person get coverage in one state but not in another?

Answer: The insurance industry is regulated on a state-by-state basis. There is no uniformity. There are enormous differences in disqualifying medical conditions.

Q: You cite PacificCare, which might exclude anyone who takes prescription medications for high blood pressure, acid reflux, asthma, migraines, arthritis. Aetna won't insure anyone who has had a hip or knee replacement. Other insurers have equally onerous health hurdles. Some of those conditions are tough to avoid after 50. What alternatives do we have?

A: It is very shocking to a lot of people. There is no good answer for the way the individual insurance system works today. People just don't realize they are only paying 25 percent or 30 percent of the premium when they have group insurance. Consumer Reports found that the median out-of-pocket medical expenses for the last 12 months were $2,264 for those with individual insurance vs. $973 for those with employer-based plans.

Q: You have many tales of insurance woe in your article. What's a person to do?

A: Start by going to www. healthinsuranceinfo.net to check out coverage in your state. You really need to be careful leaving a group plan. There is a little window for coverage.

The federal Health Insurance Portability and Accountability Act provides some protection if you are switching from job-based group coverage to an individual plan even if you have a medical condition that could preclude insurance.

But to exercise your HIPAA rights, you first have to exhaust all job-based coverage available, including COBRA, which allows you to continue in your employer's plan for 18 months by paying the full cost plus 2 percent.

HIPAA is like a get-out-of-jail-free card for people with pre-existing conditions. But you must apply for individual coverage within 63 days after your old coverage ends.

Every state has to make sure there is at least one policy available to you if you meet these conditions.

Q: Other suggestions?

A: Know your state laws.

Q: What are other ways people can educate themselves?

A: Go to www. consumerreports.org/health for unbiased comparisons and www.eHealthInsurance.com for links to hundreds of insurance plans across the country.

By Alan Ray  LBHR with Dr. De Smet  12/15/2004 

THE APPEAL LETTER TO CIGNA (NAU IS "national appeals unit") 
 Dear CIGNA NAU: 
 I have received your written notice, dated Aug. 27, 2004, denying my initial request for pre-authorization for left hip surface arthroplasty. With this letter and attachments, the request is being re-submitted for further consideration as an appeal of the initial denial.
 
 I am a 55-year-old male diagnosed in March of this year with end-stage osteoarthritis of the left hip, with “some component of dysplasia”.  The result of the condition is that I am unable to engage in the athletic activities that have helped me control hypertension and maintain extremely low blood cholesterol levels (as demonstrated in my past two annual
 physicals). Despite a high-stress professional position and extremely demanding work schedules, I have managed to maintain my health…with the help of competitive handball, three to four times a week, and a rigorous regime of weight-resistance training, and aerobic conditioning. Now the activities that helped keep me healthy are closed to me.
 
 The physician who provided the initial diagnosis also made clear that, with a Total Hip Replacement, these activities would be closed to me for as long as I live. With that word from him, I set out to find an alternative.
 
 It is clear, from what I have read in the professional literature that, with a Total Hip Replacement, in addition to a high level of surgical and post-operative complications, there is an exceedingly high likelihood of dislocation in even basic activities...
 
Read More