Press Release -- AJKD paper: Erythropoiesis-Stimulating Agent Use Among Non-Dialysis-Dependent CKD Patients Before and After the Trial to Reduce Cardiovascular Events With Aranesp Therapy (TREAT) Using a Large US Health Plan Database.
We are pleased to announce the publication of our AJKD paper. We report that "TREAT appears to be a watershed study that was followed by a marked decline in ESA prescribing for patients with CKD." In this case, the decision to reduce ESA dose was made by individual physician who manage anemic pre-dialysis chronic renal disease (CKD) patients.
We find that these AJKD results stand in stark contrast to our previously published BMC Nephrology paper: Influence of safety warnings on ESA prescribing among dialysis patients using an interrupted time series. We reported that "ESA therapy had been both profitable for providers and controversial regarding benefits for nearly two decades. The extent to which a FDA black box warning highlighting important safety concerns influenced use of ESA therapy among nephrologists and dialysis providers was unknown. Our study found no evidence of changes in ESA prescribing for the overall dialysis population resulting from a FDA black box warning." In this case, the decision not to reduce ESA dose was made by dialysis providers (i.e. chains and individual dialysis centers) who manage anemic end-stage renal disease patients.
The research for this article was supported, in part, by the Agency for Healthcare Research and Quality (AHRQ) Grant 5R03HS020572. Data was procured from funds available through AHRQ Grant R03HS018697.
We find the contrast between the two studies to be insightful in regard to how both small and large organizations differ from individual physicians in both their perception of risk to the patient and their actions.
The Principal Investigator for both studies is Mae Thamer PhD, Director of Research at MTPPI