Recent Developments
Tanning Tax Debate Emerging
A panel of 25 Congressional Representatives has proposed legislation (H.R. 2092) to repeal the tanning tax.
The legislators say the tax is a burden on small business owners and hurts the economy. At the least,
opponents of repeals say, elimination of the tax could
risk public health. If repeal rekindles interest in a cosmetic surgery tax, it could spell problems for dermatologists confronted with a slow economic recovery.
The American Academy of Dermatology Association
(AADA) and the Dermatology Nurses’ Association
(DNA) are among groups publicly opposed to repeal.
In addition to voicing opposition to H.R. 2092,
DNA also recently launched its newly redesigned
website: dnanurse.org. New features include a
Community tab, where members can submit and
respond to blog posts, post documents, pose questions
and polls to colleagues and create groups for networking purposes. Also new is a Career Center.
Prescription Assistance Programs Underway
Prescription drug assistance programs are now available to reduce health insurance co-payments for six
primary dermatological brands from PharmaDerm.
Under the programs, patients will pay $10-30 out-ofpocket for Adoxa 150mg (doxycycline capsules),
Apexicon E (diflorasone diacetate USP 0.05% emollient) Cream, Cutivate (fluticasone propionate) Lotion
0.05%, Oxistat (oxiconazole nitrate) Cream 1% and
Lotion 1%, Solaraze (diclofenac sodium) Gel 3%, and
PAs in Dermatology Hit Capitol Hill as Part of First Annual SDPA Lobby Day
By Lauren R. Zajac MHS, PA-C and
Kristin Butterfield, AAPA Director of Grassroots Advocacy
Seeking to capture a “critical mass” of PAs in town for the Society for
Dermatology Physician Assistants' (SDPA) annual meeting this summer and have them raise awareness of the profession and seek support for legislative priorities on Capitol Hill, the SDPA in conjunction
with the American Academy of Physician Assistants (AAPA) held their
inaugural Capitol Hill Day June 2. In addition to helping advance legislative priorities in Congress, the advocacy event complemented and
enhanced the SDPA Summer CME meeting, adding a new dimension to
the standard conference seminars. “I left feeling that it was a great
educational experience,” said Sandra Woods, PA-C.
The collaboration between AAPA and SDPA is part of AAPA's advocacy strategic plan. A relatively new initiative, it seeks to engage PAs
who are already coming to Washington, DC, for meetings with specialty or constituent organizations and ask them to take part in
advocacy activities on Capitol Hill. Facilitated and funded by AAPA,
the program seeks to harness the tremendous power of PAs delivering a unified message “en mass” to Congress into positive
change for the profession.
Prior to arriving in Washington, participants received background
information and training via webinar. AAPA staff set up a “Hill Day
Command Center” at the SDPA meeting hotel, providing onsite
troubleshooting, information, and logistical assistance.
Participants were also given leave-behind materials to bolster their
conversations with legislators' offices. Well-prepped for their
meetings, the PAs then departed for Capitol Hill for face-to-face
meetings with Senators and Representatives and their staff on
issues such as direct reimbursement for PAs under Medicare and
FDA classification of tanning beds. “We were eased into it, with the
webinar and information ahead of time. Short and to the point, it
was really well done,” observed Vicki Roberts, PA-C.
A key component of legislative advocacy on the Hill is developing
relationships with legislators and staff. Having meetings with legislators offices both in Washington and in the district back home
are excellent ways to foster and strengthen those relationships.
Often the office's first contact with the PA profession is through a
PA advocate, who is then frequently sought out for perspective and
advice on legislative issues by the Member or staff.
SDPA Hill day participants and all PA advocates are encouraged to
keep up the relationships with email, phone and in-person contacts throughout the year. AAPA offers many opportunities and
tools to facilitate this, such as action alerts and annual advocacy
events.
For more information about advocacy or AAPA's legislative conference, Capitol Connections, in March 2012, contact Kristin
Butterfield, AAPA's Director of Grassroots Advocacy, at
kbutterfield@aapa.org.
August 2011 |
Practical Dermatology | 9
Recent Developments
Veregen (sinecatechins) Ointment 15%. The programs
reduce the patient's out-of-pocket costs through the
use of Instant Savings Cards that can be obtained
directly from a doctor's office. Patients present the
card to their pharmacists.
Leukemia Drug May Be Beneficial for Some Melanomas
Imatinib (Gleevec, Novartis), an agent indicated for
the treatment of leukemia, demonstrated significant
activity in patients with metastatic melanoma harboring genetic c-Kit aberrations in a recent study (Journal
of Clinical Oncology; 29(21): 2904-9). The phase II trial
enrolled 43 patients with metastatic melanoma harboring c-Kit aberrations, each who received continuous dose of imatinib 400mg daily. Fifteen patients
who experienced progression of disease escalated to
800mg/day. Results indicated that the rate of total disease control was 53.5 percent, with 23.3 percent and
30.2 percent achieving PR and SD, respectively.
Median PFS and OS times for patients who had PR or
SD versus disease progression were nine months versus 1.5 months and 15 months versus nine months. In
addition, imatinib 400mg/d was well tolerated. Only
one of 15 patients who received dose escalation to
800mg/d achieved SD.
Ipilimumab Approved in Europe
The European Commission approved ipilimumab
(Yervoy, Bristol Myers Squibb) for the treatment of
adult patients with previously-treated advanced
melanoma. Yervoy showed long-term survival in the
treatment of patients with advanced melanoma in a
randomized, double-blind Phase III study published in
the New England Journal of Medicine in June 2010 (see
p. 37 for more information).
Data Support Hydroquinone Combination
New data presented at the World Congress of
Dermatology suggests that hydroquinone 4% plus
tretinoin 0.025% (NuDerm, Obagi) effectively decreases the severity of melasma, particularly in skin of
color. Statistically significant benefits were seen in
brown spots or discoloration, as well as in skin texture and fine lines and wrinkles. In addition, patients
reported that the reduction in pigment discoloration
10 | Practical Dermatology
| August 2011
Acquisitions and Mergers
Valeant continues to expand in the dermatology market, recently
announcing plans to acquire the Dermik unit from Sanofi-Aventis
and the assets of Ortho Dermatologics from Janssen
Pharmaceuticals. Valeant will pay Sanofi $425 million and Janssen
$345 million, pending approval of the sales by regulatory bodies.
PhotoMedex, marketer of the Xtac excimer laser, OmniLux LED systems, and Neova skin care products, is set to merge with Radiancy,
developer and manufacturer of the no!no! hair removal system and
other at-home and professional aesthetic devices.
ConBio, a Cynosure Company, is the new name for HOYA ConBio,
which was acquired by Cynosure.
Sciton has expanded its global reach, announcing that it will now
market its JOULE and BBLs systems in Russia through a partnership
with InMedTech.
actually decreased their self-consciousness by 60 percent and their feelings of overall unattractiveness by
45 percent. Moreover, 90 percent of patients reported
that the combination treatment was more effective or
much more effective than other medications they had
used before.
Results from a new clinical 12-week study also presented at the World Congress of Dermatology evaluating prescription strength the Hydroquinone/LAscorbic Acid Treatment System (Obagi-C Rx, Obagi)
for normal to oily skin found that the system provided improvement in overall facial appearance as well
as increased patient satisfaction. The 34 participants
in the study had a mean age of 32 years and exhibited
minimal to mild photodamage. Of the 30 patients who
completed the study, 100 percent of patients reported
that the system was good, very good, or excellent
compared with other skin treatments they had used
before. In addition, statistically significant benefits
were seen in hyperpigmentation and skin laxity as
well as improved skin texture and fine lines and wrinkles. All of the patients were either satisfied or sery
satisfied with their overall facial appearance.
Neurotrophins May Affect Development of Urticaria
New research appearing in Clinical & Experimental
Allergy suggests that neurotrophins may play role in
Recent Developments
the pathophysiology of chronic spontaneous urticaria.
For the study, researchers performed autologous
serum skin tests in 50 adult patients with chronic
spontaneous urticaria. They also analyzed BDNF
serum levels by enzyme immunoassay in the 50
urticaria patients and 23 subjects with healthy skin.
Additionally, they took skin biopsies from weals of
eight of the patients with chronic spontaneous
urticaria as well as from healthy skin of eight of the
controls to evaluate the expression of BDNF and its
receptors including tyrosine kinase (trk) B and panneurotrophin receptor p75NTR. For inclusion, chronic
spontaneous urticaria was defined as recurrent weals
for more than six weeks.
While BDNF serum levels were detectable in all
subjects, these levels were significantly higher in
patients with chronic spontaneous urticaria compared
to non-atopic skin-healthy controls. Epidermal and
dermal expression of BDNF and epidermal expression
of p75NTR was significantly higher in patients with
chronic spontaneous urticaria compared with controls. There was no difference with regard to the
expression of trkB between the two groups. BDNF
serum levels were not different between autologous
serum skin test-positive and negative patients with
chronic spontaneous urticaria. ■
Correction
In the May 2011 edition, the “Clinical Focus” column discussing
management of truncal acne listed BenzEFoam 5.3% (Onset
Dermatologics) with an incorrect percentage of benzoyl peroxide.
Please note that the formulation is BenzEFoam 5.3%.