Money Driven?
Morally Deficient?
Massively Despicable?
Dialysis centers, the freestanding facilities that clean the blood of people with late-stage kidney disease, have lately been accused of inflating profits by giving patients unneccessarily high doses of expensive anemia drugs.
A study published today in JAMA should keep the controversy rolling. The authors conclude that for-profit dialysis centers give patients significantly higher doses of the drugs than non-profit centers — a disparity caused in part by Medicare reimbursement.
The drugs are known as ESAs, (or, loosely, as EPO) and they include Epogen and Aranesp, both made by Amgen. (J&J sells similar drugs, Procrit and Eprex, which aren’t used for dialysis patients in this country.) All these drugs stimulate the body to produce more red blood cells, which contain oxygen-carrying hemoglobin. Some research has suggested that aggressive use of the drugs, to boost patients to hemoglobin levels higher than those recommended by the FDA, could be beneficial.
But a JAMA editorial that appears along with the study argues otherwise.
The author, Daniel Coyne of Washington University School of Medicine, notes that some studies “have shown that higher hemoglobin levels correlate with lower hospitalization rates, fewer cardiovascular events, and better survival in dialysis patients.” But Coyne argues that those findings are problematic because the sickest patients tend to have hemoglobin levels that remain low in spite of aggressive treatment with drugs. Instead, Coyne focuses on several randomized trials in which one group of patients was given enough drugs to bring hemoglobin levels into the FDA’s targeted range, while another group was treated more aggressively to boost hemoglobin even higher. Those studies consistently show better outcomes when patients are treated to meet, but not exceed, the FDA hemoglobin guidelines, he writes.
More at WSJ Health Blog
Insider is a vocal critic of Big Pharma and some of the shenannegins they get up to.
But it takes two to tango.
Time for the spotlight to shine on the MD's, perhaps?
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