DPC Urges Caution in Implementing GAO Report Recommendations

Dec 10, 2012, 16:33 ET from Dialysis Patient Citizens

WASHINGTON, Dec. 10, 2012 /PRNewswire-USNewswire/ -- Dialysis Patient Citizens issued the following statement in response to today's release of the Government Accountability Office (GAO) report entitled "End-Stage Renal Disease: Reduction in Drug Utilization Suggests Bundled Payment Rate is Too High":

"Dialysis Patient Citizens (DPC) is extremely concerned by the GAO's findings of an apparent decline in drug utilization for dialysis patients, but urges restraint and careful consideration prior to acting on the report's conclusions. While DPC appreciates the desire to identify potential efficiencies in the Medicare End Stage Renal Disease (ESRD) Program, we strongly caution the GAO, the Department of Health and Human Services, the Centers for Medicare and Medicaid Services and Congress not to act too hastily on the report's findings.

Following implementation of the new bundled payment system for dialysis and the subsequent changes in the Food and Drug Administration's dosing guidelines for erythropoietin stimulating agents (ESAs), it is clear there have been substantial changes in utilization patterns for ESAs, intravenous (IV) iron and IV vitamin D. However, the patient impact of this reduction in utilization is unclear, as noted in the GAO report. In fact, while it appears that the decline in ESA utilization has led to an increase in transfusion rates, the incident of heart attacks and strokes has declined. As a result, the ESRD clinicians interviewed for the GAO report stated that there is 'limited clinical evidence available…to determine the impact on beneficiaries of recent changes in ESRD drug utilization.'

Because the impact of these variations are so uncertain, we urge a thoughtful analysis of the changes to patient care and patient outcomes before any decisions are made to adjust compensation for these drugs. Additionally, we urge policy makers to ensure that any potential modifications to ESRD reimbursement take into consideration the entire bundled payment system and not simply these changes in isolation. We hope to work with the Administration, Congress and the kidney community to ensure both optimal utilization and payment rates so patients receive the high quality care they deserve."

Read the full GAO report here: http://www.gao.gov/assets/660/650667.pdf.  

About Dialysis Patient Citizens: 

DPC is America's largest patient-led organization representing dialysis patients. With a membership of more than 24,000 dialysis and pre-dialysis patients and their families, DPC's mission is to improve the quality of life of dialysis patients by engaging policy makers, providers and the public. Through patient education, empowerment and advocacy, DPC works to increase awareness about kidney disease and promote favorable public policy. 

Jessica Nagro

SOURCE Dialysis Patient Citizens