Study Urges Caution on Anemia Drug Use

A flawed Medicare payment plan encourages aggressive use of a risky and costly anti-anemia drug on many kidney dialysis patients, say researchers who warn the system should be changed.

A new study finds that for-profit dialysis chains give higher doses of the drug than nonprofit dialysis centers. That practice may be putting patients at risk of deadly side effects, some experts said.

The drug is Epogen, and Medicare pays more for it than any other single drug: $2 billion in 2005. For-profit dialysis chains report that the drug accounts for 20 percent to 25 percent of their annual net operating revenue. ...

The differences in use between for-profit and nonprofit centers was not because certain patients were sicker, the researchers found. The study, appearing in Wednesday's Journal of the American Medical Association, is based on data on nearly 160,000 dialysis patients who got care in 2004.

In an accompanying editorial in JAMA, Dr. Daniel Coyne of Washington University School of Medicine in St. Louis said kidney doctors who work with dialysis centers may not know they are "making dubious dosing decisions" because they sign multipage standing orders and turn over anemia management to chain employees. ...

•	Study Urges Caution on Anemia Drug Use Associated Press Online, Wednesday, April 18, 2007 Byline: Carla K. Johnson, Associated Press Writer

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