Erythropoiesis-Stimulating Agent Use After Changes in Medicare Reimbursement Policies

Abstract

Purpose: Since 2004, concerns about the safety of erythropoiesis-stimulating agents (ESAs) have resulted in label changes and restrictions on their use. We examined changes in ESA use and blood transfusions over time. Methods Conclusion:Our study demonstrated a rapid decline in the percentage of patients treated with ESAs after changes to reimbursement policy, but not after warnings about use. Reimbursement restrictions of other overused or off-label drugs may help reduce health care expenditures.

Reply to A. Kolacevski et al

“…2 We were thrilled that the authors confirmed our findings in patients with breast cancer using CancerLinQ. 2 We were thrilled that the authors confirmed our findings in patients with breast cancer using CancerLinQ.…”

Medical costs and associated racial/ethnic and sex disparities in erythropoiesis-stimulating agent use: anemia management under the Medicare reimbursement policy

“…16,17 Arneson et al, Hershman et al, and Li et al found that the use of ESAs had a 50%-57% reduction after the policy change based on claims. [18][19][20] Specifically, Li et al identified racial/ethnic and sex disparities in the impact of the policy change on the use of ESAs. 20 Before the reimbursement policy change, Medicare paid approximately $2 billion every year to reimburse for ESAs.…”

Racial/ethnic and gender disparities in the use of erythropoiesis-stimulating agents and blood transfusions: cancer management under Medicare’s reimbursement policy

“…Some previous studies have examined the change in the use of ESAs and blood transfusions in cancer patients before and after the implementation of the Medicare reimbursement policy change. [32][33][34][35][36][37] Documented in the literature is a 26%-57% reduction in the use of ESAs after the policy change. [32][33][34][35] Results are mixed regarding the change in the use of blood transfusions.…”

“…[32][33][34][35][36][37] Documented in the literature is a 26%-57% reduction in the use of ESAs after the policy change. [32][33][34][35] Results are mixed regarding the change in the use of blood transfusions. [32][33][34][35][36][37] These studies, however, lack control groups, which cast doubt on the validity of the study results.…”

“…[32][33][34][35] Results are mixed regarding the change in the use of blood transfusions. [32][33][34][35][36][37] These studies, however, lack control groups, which cast doubt on the validity of the study results. In addition, no studies have examined disparities associated with the Medicare reimbursement policy change.…”