I Hate Dialysis Message Board
Dialysis Discussion => Dialysis: General Discussion => Topic started by: Whamo on June 20, 2012, 09:50:37 PM
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First, the good news. The Beverly Hills company that developed portable kidneys you can wear is testing them in Seattle. They weigh 10 lbs and use a catheter for access.
Now, the bad news. Medicare is changing the way it pays for dialysis, bundling drugs and treatment together. Evidently the high drug costs for Epocrit drove this decision.
Everyone can look forward to becoming anemic?
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Unfortunately the bundling notice is old. It went into effect maybe the beginning of 2011? Not sure. There's a thread about bundling under the Medicare/Insurance heading and I've seen a number of threads about people who can't get Epo. But I think most of us have adjusted to the changes as best we can. At my center they did not withhold epo so I was lucky. But there are also some issues related to the side effects of epogen that were part of the decision. I haven't followed all the details but someone here can probably help you.
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The FDA issued a black box warning several years ago on Procrit (I was taking it at the time, and it freaked me out). It was determined that too high a hg level led to a higher risk of stroke and cardiovascular problems. It seems that some dialysis clinics habitually overmedicated their patients with epo because, since it was outside the bundle, it was a lucrative revenue stream. Never mind that they were harming their patients. Now that epo is part of the bundle, some clinics don't/won't use enough of it because it is no longer so lucrative. Never mind that they are harming their patients...
We wouldn't be turning into a nanny state if people could be trusted to do what is right and not merely what is profitable.
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Jenna could not get Epogen based on her nephrologist's prescription and labs showing her hemoglobin was below 9. She had to get another lab "iron panel" before the insurance company would approve it.
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Proper iron levels are important to make EPO most effective.
Also make sure you take folic acid.
8)
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I'm sorry I don't have the link to the new notice, but it also talks about how kidney centers are changing the way they treat patients, in a bad way, because of the belt tightening.
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Personally, I'm waiting for an official notice that says my PD nurse has to stop bitching about my weight.