Medicare Proposes Changes To Target Hemoglobin Levels In ESRD Treatment
CMS aims at “retiring” the floor hemoglobin level of 10 g/dL and lowering the target upper level to 11 g/dL in its proposed rule for the Medicare Part B prospective payment system for treatment of end-stage renal disease, a move that could apply more pressure to Amgen’s erythropoiesis-stimulating agents franchise.
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Medicare’s bundling policy for drugs and services in dialysis has turned on the pricing pressure in kidney disease. The cost containment policies have negatively impacted sales of some drugs and put a spotlight on growing costs in chronic kidney disease and end-stage renal disease. Nonetheless, there is plenty of opportunity for new drugs that can address the area’s unmet medical need, especially if they can help to reduce broader health care spending. That will require demonstrating value to payors and providers, however, particularly for drugs that treat secondary conditions associated with kidney disease.
A study from the U.S. Renal Data System contributes to concerns that decreasing use of erythropoiesis-stimulating agents like Amgen’s Epogen in dialysis patients can lead to a significant increase in the need for blood transfusions.
The market for kidney disease drugs is under pressure from Medicare cost containment policies. However, there is still room for new drugs – if they can demonstrate a cost-savings benefit.