Mike Sells to Hillary Rodham Clinton re: Health Care Reform

09-02-93 THII 16:00 September 2, 1993 Mrs. Hillary Clinton First Lady of the United States The White House Washington, D.C. Dear Mrs. Clinton: My name is Mike Sells from Little Rock, Arkansas. I work at Cranford Johnson Robinson Woods with Skip Rutherford, with whom I know you are very familiar. I am writing in regard to a healthcare issue. Specifically, the recent announcement by Berlex Labs and Chiron Corporation that their new drug for the treatment of relapsing/remitting Multiple Sclerosis (MS), Betaseron, will be distributed randomly by lottery. Of the 100,000 relapsing/remitting MS patients in the U.S., only 20,000 will receive the drug until manufacturing can be increased to meet demand, possibly as late as 1995. As a board member of the National Multiple Sclerosis Society - Arkansas Chapter, and the spouse of an MS sufferer, I believe that this distribution method is very questionable and deserves close scrutiny for several reasons. 1. It eliminates input from physicians. If relapsing/remitting MS were a clearly black and white issue, it might be different. However, as any neurologist who specializes in MS can tell you, there are widely varying degrees of relapsing/remitting MS. Physicians should have input into which of their patients need the drug the most - depending upon who it will help the most and who it will most assist in arresting the development of the disease. It is important to remember that all damage done by an MS episode is permanent and irreversible Betaseron dramatically reduces one's chances of having an episode and suffering permanent damage. There are patients who are currently in bad need of the drug to stop such episodes but they may not receive it for many months under this scenario. A better alternative would be the method used for transplant lists where the determination of who gets a transplant is made based by physicians based upon who needs it the most and is most likely to benefit from it. 2. The FDA was not aware when they approved the drug that this distribution method would be employed. Furthermore, they have no oversight rights on the distribution method. 09-02-93 THII 16:00 P.03 3. This has far-reaching implications, beyond Detaseron, on the delivery of healthcare in the future which should be considered. I have asked the department of human services to investigate and scrutinize this plan closely to insure that this remarkable and life-changing medication is distributed fairly. Because of your work on healthcare issues, I also wanted to make you aware of this situation. If you have any questions, or need additional information from me, you can reach me at (501) 376-6251 during the day and at (501) 280- 0001 at night. Thank you for your time and consideration. Sincerely, Meke Seel Mike Sells CC: Ms. Carol Rasco Mr. John Greer, Arkansas Blue Cross & Blue Shield Dr. Lee Archer, University of Arkansas for Medical Sciences Ms. Teresa Johnson, National MS Society - Arkansas Chapter