They don't. They provide their bigoted hysterical spin on research.

Sorta like pharma companies that turn science into sh.t to market
drugs and sell more of them. Thus, losing sight of the benefits and
limitations of any particular intervention, CAM or drug.

        George M. Carter

***
**
http://www.forbes.com/2007/04/17/amgen-dialysis-study-biz-cz_kd_0417amgen.html?p
artner=biotech_newsletter
Sciences and Medicine
Dosing For Dollars
By This Author    Kerry Dolan
   
BURLINGAME, Calif. -

Large, for-profit dialysis chains administered significantly more of
Amgen's blockbuster anti-anemia drug Epogen than did not-for-profit
dialysis centers, a study published today in The Journal of the
American Medical Association found.

The study was authored by Dr. Mae Thamer of the Medical Technology and
Practice Patterns Institute, a research institute in Bethesda, Md.,
and five other researchers. The authors used Medicare claims data to
examine Epogen dosage for 159,500 dialysis patients in December 2004.

For-profit facilities used an average dose of Epogen, also known as
epoetin, that was 20,838 units per week--16% higher than the average
dose at nonprofit facilities, the study found. An editorial that
appears in the same issue of JAMA notes that the 2004 Medicare
reimbursement rate of $10 per 1,000 units of Epogen corresponded to
$1,700 a year per patient in higher expenses for the higher average
dose.

The higher doses of Epogen are more than just an economic issue--they
could pose a health risk as well. There has been much debate among the
kidney care community lately about the appropriate targets to use when
giving Epogen.

The conclusions in the JAMA study also underline flaws in the way
Medicare reimbursement for dialysis treatment is currently structured.
Most of the 335,000 kidney failure patients in the U.S. who receive
dialysis are covered by Medicare, no matter how old they are.
Typically, Epogen, a red-blood-cell-boosting drug, is given
intravenously during a patient's weekly dialysis session. Medicare
reimburses dialysis centers directly for this treatment at a fixed
amount. But reimbursement for the use of Epogen is not capped;
instead, it is based on the amount of the drug that is used. Perhaps
not surprisingly, Medicare spends more money on Epogen--nearly $2
billion--than on any other drug.

Dialysis chains such as DaVita (nyse: DVA - news - people ) and
Dialysis Corporation of America (nasdaq: DCAI - news - people )
usually receive volume discounts for drugs such as Epogen, so the
chain makes a profit on the spread between the discounted purchase
price and the higher Medicare reimbursement rate.

Medicare also reimburses at 6% above the average sales price of the
drug. A Morgan Stanley report estimated that dialysis chains made 25%
of their profits on the Epogen spread. Last year 21% of DaVita's
revenue came from reimbursements for Epogen.

Part of the problem is Medicare's low rate of reimbursement for the
dialysis service. The rate has changed very little in the last two
decades, and because it has not been adjusted for inflation, the real
dollar value that dialysis centers receive for their services has
declined by about 65%.

"There is no question the potential for using Epogen as a profit
center is out there," says Dr. Jeffrey Berns, a professor of medicine
at the University of Pennsylvania and a kidney care specialist. "The
government has known about this all along. [Medicare] has had plenty
of opportunities to address this. One is to pay a fair price for the
dialysis service itself"--which Berns believes has not happened.

"It's almost a wink, wink kind of thing: We [Medicare] can't get an
increase in monthly dialysis payments through Congress," so go ahead
and use Epogen as a profit center. "Now it's coming back to bite
them," Berns says.

Studies published last year showed increased health risks associated
with higher levels of hemoglobin, the oxygen-containing protein in the
blood, in chronic kidney disease patients and cancer patients being
treated for anemia resulting from chemotherapy. This led the U.S. Food
and Drug Administration to put its strongest black-box warning on
Epogen and two similar drugs, Aranesp and Procrit, in early March.

Aranesp is an Amgen (nasdaq: AMGN - news - people ) drug used to treat
anemia in cancer patients undergoing chemotherapy, and Procrit is a
Johnson & Johnson (nyse: JNJ - news - people ) drug that competes with
Aranesp. The warning states that use of the anti-anemia drugs results
in "an increased number of deaths and of non-fatal heart attacks,
strokes and heart attacks" when the drugs were used to target
hemoglobin levels higher than 12 grams per deciliter.

Various bodies, including the U.S. House of Representatives' Ways and
Means Committee and MedPac, the federal government's Medicare Advisory
Panel, have discussed changing the way Epogen is reimbursed, in order
to improve patient safety and remove the profit incentive to use
higher doses of Epogen.

The JAMA study comes at a difficult time for Amgen, the most
profitable biotechnology company in the world. In addition to
receiving the black-box warning, Amgen has received disappointing
results on a number of clinical trials, including one that might have
expanded use of Vectibix, a cancer drug approved last fall. Its stock
has fallen 23% from a 52-week high of $77. Last week the company's
chief financial officer resigned.

On April 16, full results were released from a study showing that
patients with cancer who did not have anemia because of their
chemotherapy were significantly more likely to die if they received
Aranesp. Such use, though not sanctioned by the FDA, represents
perhaps a tenth of the use of anemia drugs.

"I think doctors in general are going to be cautious about prescribing
these agents in the cancer of anemia setting," says David P. Steensm,
of the Mayo Clinic in Rochester, Minn., at a press conference. He was
not affiliated with the study. "The black-box [warning] makes people
pay attention." He emphasized that it is not clear why Aranesp would
decrease survival.

The scrutiny of Amgen's drugs is far from over. On May 10, an FDA
panel is scheduled to discuss the safety of Epogen, Aranesp and
Johnson & Johnson's Procrit.

Again--so what? Their interpretation is in question. I do not trust
their interpretation.

You may read and swallow their bullshit as is your wont. I'm not
interested in their bullshit propaganda and vile distortions. Any
credibility they may have had long ago evaporated for me.

        George M. Carter

hi , boy you guys get snakey!  how about newstarget.com? i suss their stories
and they always check out ok, and the cite full ref,s not cut,n,clips. havent
seen quackwatch will go look am curious.
big pharma sucks! so do some small co,s. if you dont check out what your,e
taking..well ..caveat emptor!