Medicare Agrees

On June 28th, I posted an article about the new realization that kidney patients were being over-medicated with synthetic iron when dealing with their anemia problems.  I explained that this option (the synthetic iron, not the then as yet unrecognized over- medicating) had been suggested to me several times, but due to my abhorence of yet another set of needles –  it is administered intravenously – I decided to pass on the treatment and deal with the anemia via daily rest periods.

Apparently, this is an issue of great interest currently.  Medscape just posted a Reuters Health Information article dealing with this issue in dialysis patients.  While we are not yet dialysis patients, supposedly we will be eventually.  In the meanwhile, I urge you to think twice and research three times should your nephrologist suggest synthetic iron treatments for you.

From Reuters Health Information

Medicare Proposes Change in Anemia Drug Usage

by Deena Beasley


LOS ANGELES (Reuters) Jul 04 – The Medicare federal health insurance program has proposed removing its requirement
that kidney dialysis providers keep patient hemoglobin levels above a set minimum, which could lead to lower use of Epogen, the anemia drug sold by Amgen.

The government health plan said last month that it had no plans to change its reimbursement terms for anemia drugs used
to treat kidney patients.

But in a statement on its website on Friday, the agency proposed retiring a requirement that patients’ hemoglobin, or red
blood cell, levels be kept above 10 milligrams per deciliter.

It said such an action would be “consistent with revised U.S. Food and Drug Administration guidelines.”

Last week, the FDA changed the labels for Amgen’s Epogen and Johnson and Johnson’s Procrit to call for lower dosing of
the anemia drugs, which have been linked in recent years to safety concerns such as increased risk of heart problems.

“Clinicians should use the lowest dose of ESA (erythropoiesis stimulating agent) sufficient to reduce the need for red
blood cell transfusions,” Patrick Conway, chief medical officer at the Centers for Medicare and Medicaid (CMS) said in the statement.

Amgen said it recognizes that the labeling for ESAs has changed, but it is concerned that the proposal would remove an
important safeguard designed to protect dialysis patients from being undertreated.

The Medicare guidelines “should have a measure that protects patients from hemoglobin levels that fall too low,” the
biotechnology company said in an emailed statement.

Sales of the anemia drugs have declined steeply in recent years, but Amgen’s Epogen, along with its second-generation
drug Aranesp, and J&J’s Procrit are still expected to generate around $6 billion in 2011 sales, according to data from Thomson Reuters Pharma.

The proposed change would apply under Medicare’s quality performance standards for “bundled” payments to dialysis
providers and would affect payment years 2013 and 2014, the agency said.

CMS projected that its payment rates for dialysis treatments would increase by 1.8 percent in 2012, representing
projected inflation of 3 percent less a projected productivity adjustment of 1.2 percent. It also estimated that federal payments to dialysis facilities in 2012 would total $8.3 billion.

While Medicare traditionally covers just elderly and disabled Americans, kidney disease patients are an exception. The
program covers all those with end stage renal disease under a decades-old law.

Medicare said it would accept comments on the proposed rule until the end of August and will respond to them in a
final rule to be issued by November 1.

The posting may be found at: want to remind you that I am not a dialysis patient, simply an early stage chronic kidney disease sufferer yet epogen intravenously twice a month was recommended for me.  I made my decision about this for my own reasons, but only after I explored the option.  Should it be recommended to you, you need to do the same.  Our nephrologists try to keep us in as good kidney health as possible, try to keep us informed, and try to keep us up on the latest findings, but you are the one in charge.

Mulling that over as you enjoy your weekend might be a good idea.
Until Friday,
Keep living your life!



Published in: on July 8, 2011 at 9:28 am  Leave a Comment  

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