William, Tom, and everyone else, Regarding compassionate use: I am not an expert by any means, but I can tell you how it works at the hospital where I am employed part time. A physician initiates the request on behalf of a patient. The request next must be approved by the Institutional Review Board (every hospital has one of these, although it may have different names in different places), which is a panel of doctors set up by the hospital ot protect human subjects of research (because compassionate use only has to be requested if the drug can't be obtained by other -legal- means, it is considered a research item). If the IRB approves, and it usually does, since doctors tend to ask only in extraordinary circumstance, the formal request is made to the pharmaceutical company that makes the drug. I presume that every drug company has its own equivalent of an IRB to review these requests. If the pharmaceutical company agrees to compassionate use, it supplies the drug to the requesting physician, who supervises the patient who is going to get the drug. If the pharmaceutical company refuses, there is probably an appeal mechanism, but I am unfamiliar with it. The hospital makes these requests rarely, and usually in life and death situations. Maybe someone on this list (like the Glaxo person who monitors it) can fill in the blanks about what happens when a request is turned down. And maybe a doctor in private practice can fill in the blanks about how these requests are handled in the non-hospital world. Finally, I don't know how to move this discussion to the BB, where there are probably at least 100 people who can answer the questions, but I'm sure Jeff will get it over there in the proper place. Julia