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May 10, 2007
epoetin misuse
An editorial in JAMA April 18 exposes what appears to be a for profit scam on the drug used to combat anemia in dialysis patients. Actually, the study published by Thamer et al provides the evidence and Dr. Coyne draws the obvious conclusions. Basically, for-profit dialysis centers are unnecessarily aiming for much higher hemoglobin levels, based on misinterpreted evidence. in this way, they make $1700/yr per patient from the government reimbursement. At 309,000 patients on dialysis (2004 figures), that is much waste.
There is no survival benefit to this extra treatment. There may even be an increase in mortality (demonstrated by the CREATE and CHOIR trials ironically, as well as some others showing increased strokes).
Amgen, the company manufacturing this, of course bears no culpability. And the doctors prescribing it surely don't know any better. And the centers profiting from this aren't actually prescribing it. The perfect crime.
| By Robert Maddox | 06:45 PM