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Makers of blood products settle US HIV suits
THE LANCET
POLICY AND PEOPLE
T
he Irish government has agreed to pay aggravated damages to people who contracted hepatitis C virus through contaminated blood and blood products. This is in addition to money being awarded by a tribunal set up to compensate recipients of infected anti-RhD. A separate tribunal dealing with blood transfusion cases is still to be established. The government, bowing to public pressure, has upped its offer for aggravated damages to 20% above the tribunal awards. According to legal experts, aggravated damages in court cases average 15%. The first compensation tribunal has so far heard only 310 cases; more than 1400 people have hepatitis C which can be traced to infected anti-RhD. Awards so far total £Ir 34·8 million. The total payout could eventually top £300 million. In the past 30 months, more than 62 000 people have been tested for hepatitis C after news that women had first received infected anti-RhD 20 years ago.The contamination was made public in 1994 and two investigations have established that the country’s Blood Transfusion Service Board (BTSB) not only knowingly took blood for processing from two donors with a history of jaundice, but also continued to issue the infected blood product even after the scandal became apparent. The BTSB has admitted liability and made several public apologies. A judicial review of the scandal reported to the government in March naming several doctors, including the then-head of BTSB, for their laissez faire attitude to the contamination crisis and complacent management. The cabinet subsequently referred the judicial report to the director of public prosecutions. The BTSB has since found that blood donations are decreasing and shortages have threatened on a number of occasions. There is also growing evidence that patients are increasingly reluctant to accept blood products—even in life-saving procedures. Such difficulties in supply and usage are increasing interest in autologous transfusion. Karen Birchard
Vol 349 • May 17, 1997
Makers of blood products settle US HIV suits receive $12·2 million. Another our manufacturers of blood and $18 million will be paid to private plasma products have reached a insurers and state governments. settlement with patients, mostly Esnouf says agreements with all 50 haemophiliacs, who were infected states are expected with HIV-1 by those within a month— products in the 25 states have already 1970s and 1980s. agreed. With an extra About 5500 patients $40 million for legal will each receive and administrative US$ 100 000 under fees, the total payout the settlement will be $670 million. approved by a federal The companies judge in Chicago, hope “that the settleon May 7. These Bruised but not infected ment will provide patients had already overall the sort of closure that people agreed to the sum last November; are looking for”, says Esnouf. Some another 450 people are still pursuing states are passing laws to extend the litigation. 3-year statute of limitations so more Company payouts are according to patients can sue, but Esnouf says furmarket share—45% for Bayer, 20% ther litigation is unlikely. Of 16 cases for Baxter International, 20% for that have gone to trial, 14 have been Rhone-Poulenc Rorer’s Armour diviwon by manufacturers. Despite this sion, and 15% for Green Cross’ record, the firms wanted to settle to Alpha Therapeutics—says Guy end 10 years of wrangling with peoEsnouf, spokesman for the four ple who continue to be customers, companies. adds Esnouf. The settlement with Patient litigation is only one aspect patients will stand unless it is of the tainted-blood brouhaha. The appealed by June 7. Companies will US government, which has paid for begin payments by July. some of these patients’ care through Medicare, Medicaid, and other federal insurance programmes, will Alicia Ault Barnett
F
Science Photo Library
Government to pay for Irish hepatitis C scandal
US employers ignore hospital mortality data ospital mortality and morbidity data have not yet been embraced by large employers when buying health coverage, according to a study due out this summer. Many employers do not rely on these data nor do they know they even exist, according to Judith Hibbard, professor of health policy at the University of Oregon, who presented her findings at a meeting sponsored by the Center for Studying Health System Change, held in Washington DC, USA. Hibbard surveyed 33 large employers, covering 1·3 million employees in California, New York state, Pennsylvania, and Cleveland. Awareness of the availability of hospital death rate trends varied widely across the board. The bulk of purchasers she interviewed said that hospital data had little to do with their purchasing decisions because the data are not reliable or timely. It was assumed that managed-care plans looked at the data, and purchasers trusted their decisions. Another reason why larger employers
H
were not interested in hospitalspecific data for a particular region was because they often have to buy health coverage in more than one state, making it difficult to choose a hospital. The study also found that employers have much progress to make when it comes to employees’ education. Nearly one third of employers said they passed on performance data to help employees pick out health plans; another 15% said they were planning to do so in future. Many employers remained sceptical about the utility of the information and whether it was used or understood by employees. Clark Kerr, president of the California-based Consumer First, says he worries that employers are underestimating employee interest in the data. He and others say employers need to make more efforts to find out what employees are interested in when it comes to choosing a health plan. Janet Firshein
1459
POLICY AND PEOPLE
T
he Irish government has agreed to pay aggravated damages to people who contracted hepatitis C virus through contaminated blood and blood products. This is in addition to money being awarded by a tribunal set up to compensate recipients of infected anti-RhD. A separate tribunal dealing with blood transfusion cases is still to be established. The government, bowing to public pressure, has upped its offer for aggravated damages to 20% above the tribunal awards. According to legal experts, aggravated damages in court cases average 15%. The first compensation tribunal has so far heard only 310 cases; more than 1400 people have hepatitis C which can be traced to infected anti-RhD. Awards so far total £Ir 34·8 million. The total payout could eventually top £300 million. In the past 30 months, more than 62 000 people have been tested for hepatitis C after news that women had first received infected anti-RhD 20 years ago.The contamination was made public in 1994 and two investigations have established that the country’s Blood Transfusion Service Board (BTSB) not only knowingly took blood for processing from two donors with a history of jaundice, but also continued to issue the infected blood product even after the scandal became apparent. The BTSB has admitted liability and made several public apologies. A judicial review of the scandal reported to the government in March naming several doctors, including the then-head of BTSB, for their laissez faire attitude to the contamination crisis and complacent management. The cabinet subsequently referred the judicial report to the director of public prosecutions. The BTSB has since found that blood donations are decreasing and shortages have threatened on a number of occasions. There is also growing evidence that patients are increasingly reluctant to accept blood products—even in life-saving procedures. Such difficulties in supply and usage are increasing interest in autologous transfusion. Karen Birchard
Vol 349 • May 17, 1997
Makers of blood products settle US HIV suits receive $12·2 million. Another our manufacturers of blood and $18 million will be paid to private plasma products have reached a insurers and state governments. settlement with patients, mostly Esnouf says agreements with all 50 haemophiliacs, who were infected states are expected with HIV-1 by those within a month— products in the 25 states have already 1970s and 1980s. agreed. With an extra About 5500 patients $40 million for legal will each receive and administrative US$ 100 000 under fees, the total payout the settlement will be $670 million. approved by a federal The companies judge in Chicago, hope “that the settleon May 7. These Bruised but not infected ment will provide patients had already overall the sort of closure that people agreed to the sum last November; are looking for”, says Esnouf. Some another 450 people are still pursuing states are passing laws to extend the litigation. 3-year statute of limitations so more Company payouts are according to patients can sue, but Esnouf says furmarket share—45% for Bayer, 20% ther litigation is unlikely. Of 16 cases for Baxter International, 20% for that have gone to trial, 14 have been Rhone-Poulenc Rorer’s Armour diviwon by manufacturers. Despite this sion, and 15% for Green Cross’ record, the firms wanted to settle to Alpha Therapeutics—says Guy end 10 years of wrangling with peoEsnouf, spokesman for the four ple who continue to be customers, companies. adds Esnouf. The settlement with Patient litigation is only one aspect patients will stand unless it is of the tainted-blood brouhaha. The appealed by June 7. Companies will US government, which has paid for begin payments by July. some of these patients’ care through Medicare, Medicaid, and other federal insurance programmes, will Alicia Ault Barnett
F
Science Photo Library
Government to pay for Irish hepatitis C scandal
US employers ignore hospital mortality data ospital mortality and morbidity data have not yet been embraced by large employers when buying health coverage, according to a study due out this summer. Many employers do not rely on these data nor do they know they even exist, according to Judith Hibbard, professor of health policy at the University of Oregon, who presented her findings at a meeting sponsored by the Center for Studying Health System Change, held in Washington DC, USA. Hibbard surveyed 33 large employers, covering 1·3 million employees in California, New York state, Pennsylvania, and Cleveland. Awareness of the availability of hospital death rate trends varied widely across the board. The bulk of purchasers she interviewed said that hospital data had little to do with their purchasing decisions because the data are not reliable or timely. It was assumed that managed-care plans looked at the data, and purchasers trusted their decisions. Another reason why larger employers
H
were not interested in hospitalspecific data for a particular region was because they often have to buy health coverage in more than one state, making it difficult to choose a hospital. The study also found that employers have much progress to make when it comes to employees’ education. Nearly one third of employers said they passed on performance data to help employees pick out health plans; another 15% said they were planning to do so in future. Many employers remained sceptical about the utility of the information and whether it was used or understood by employees. Clark Kerr, president of the California-based Consumer First, says he worries that employers are underestimating employee interest in the data. He and others say employers need to make more efforts to find out what employees are interested in when it comes to choosing a health plan. Janet Firshein
1459