Medicare may alter anemia drug payments for dialysis

Medicare needs to change the way it pays for anemia drugs to discourage excessive use in kidney dialysis patients, a key lawmaker said Tuesday.

The federal health insurance program for the elderly and disabled spends about $2 billion annually on Amgen Inc.’s Epogen, part of a class of anti-anemia drugs called erythropoiesis-stimulating agents (ESAs).

Critics say current payment methods have promoted aggressive treatment. Concern grew when recent studies showed high doses could lead to heart complications or death.

“Medicare can be a better purchaser of care for dialysis beneficiaries, and can do so in a way that ensures more efficient use of ESAs and better health outcomes for beneficiaries,” said Rep. Pete Stark (D-Fremont), chairman of the House Ways and Means health subcommittee.

Some experts advocate bundling payments for the drugs with the payments for kidney dialysis services, which they say would encourage doctors to use only as much drug as needed.

“Bundled payments would encourage more efficient use of ESAs,” Stark said at a subcommittee hearing.

Amgen, in written testimony submitted to lawmakers, said most Epogen use in dialysis “has been and continues to be appropriate.” Doctors have become more conservative in prescribing Epogen for dialysis patients, the company said.