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Doctors Reap Millions for Anemia Drugs
Key Excerpts from Article on Website of New York Times


New York Times, May 9, 2007
Posted: May 14th, 2007
http://www.nytimes.com/2007/05/09/business/09anemia.html?ex=...

Two of the worlds largest drug companies are paying hundreds of millions of dollars to doctors every year in return for giving their patients anemia medicines, which regulators now say may be unsafe at commonly used doses. The payments are legal, but very few people outside of the doctors who receive them are aware of their size. The payments give physicians an incentive to prescribe the medicines at levels that might increase patients risks of heart attacks or strokes. At just one practice in the Pacific Northwest, a group of six cancer doctors received $2.7 million from Amgen for prescribing $9 million worth of its drugs last year. [A] report prepared by F.D.A. staff scientists said no evidence indicated that the medicines either improved quality of life in patients or extended their survival. Several studies suggested that the drugs can shorten patients lives when used at high doses. The medicines ... are among the worlds top-selling drugs. They represent the single biggest drug expense for Medicare. Since 1991 ... the average dose given to dialysis patients in this country has nearly tripled. About 50 percent of dialysis patients now receive enough of the drugs to raise their red blood cell counts above the level considered risky by the F.D.A. Unlike most drugs, the anemia medicines do not come in fixed doses. Therefore, doctors have great flexibility to increase dosing and profits. The companies have [failed] to test whether lower doses of the medicines might work better than higher doses. There is little evidence that the drugs make much difference for patients with moderate anemia, and federal statistics show that the increased use of the drugs has not improved survival in dialysis patients.

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