GAO Tracks Decline In ESA Use Following Regulatory Changes
This article was originally published in The Pink Sheet Daily
A Government Accountability Office report finds that use of erthryopoiesis-stimulating agents in dialysis decreased 31% from 2007 to the end of 2011 after Medicare’s bundled dialysis payment was changed to include drugs and FDA revised dosing recommendations.
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CMS was directed by the American Taxpayer Relief Act to “rebase” the ESRD payment level by re-calculating the use of erythropoiesis-stimulating agents and other infused or injectable therapies.
Experience with the end-stage renal disease prospective payment system reveals a valuable lesson – that patient-related quality metrics are needed to fully assess the impact the system has on the patient, something that will be valuable when bundling is considered for treatments where drug costs are significant.
Dialysis centers write to CMS saying that upcoming Medicare payment cuts for end-stage renal disease treatment, combined with a 5% Epogen price increase, will put “additional pressure on already thin Medicare margins.”