Epogen, Procrit and Aranesp: ineffective, too expensive, and dangerous?

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The Washington Post has an article out (an “exclusive”) about three drugs used to treat anemia that their investigative reporting seems to show are less effective and more dangerous than people thought. Here’s the dramatic intro from the WP’s article:

On the day Jim Lenox got his last injection, the frail 54-year-old cancer patient was waiting to be discharged from the Baltimore Washington Medical Center…. a nurse said he needed another dose of anemia drugs.

His wife, Sherry, thought that seemed odd, because his blood readings had been close to normal, but Lenox trusted the doctors. After the nurse pumped the drug into his left shoulder, the former repairman for Washington Gas said he felt good enough to play basketball.

The shots, which his cancer clinic had been billing at $2,500 a pop, were expensive.

Hours later, Lenox was dead.

This is a very interesting article, and it will be very interesting to see how this plays out. Big Pharm is the bad guy, The Taxpayers are getting bilked, and innocent bystanders like Mr. Lenox are the victims. This could be a very important piece of journalism which will change the world in a positive direction, or it could be a misunderstanding of the way drugs and the drug industry and related medical practice all work. The implications, accusations even, that are being made are pretty serious. Drug companies engineered the pricing and dosage so that doctors would make money if they prescribed these drugs, and this kept the drugs flowing despite evidence that maybe they should be used less or not at all. Even “beaurocrats” and Congress were in on the conspiracy. Drug makers ….

…offered discounts to practices that dispensed the drug in big volumes. They overfilled vials, adding as much as 25 percent extra, allowing doctors to further widen profit margins. Most critical, however, was the company’s lobbying pressure, under which Congress and Medicare bureaucrats forged a system in which doctors and hospitals would be reimbursed more for the drug than they were paying for it.

… and so on and so forth.

I worry about this kind of finding for two reasons. First, all the usual bad guys are the bad guys and all the usual victims are the victims, so everyone is going to get all breathless and bent out of shape over this, even if there is really no story here. That’s one reason I worry. The other reason is that this could all be real…there could be a problem exposed here that needs to be fixed, but because it looks like the usual bashing of the medical profession, wagons will be drawn into circles and smart looking medical professoinals are going band together to convince, for example, the skeptical community that this is just a bunch of yellow journalism.

In other words, I suspect we are about to see an all out tribal war. What we really need, of course are facts and reasonable interpretations.

I’m looking forward to the input of Science Based Medicine bloggers on this.

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8 thoughts on “Epogen, Procrit and Aranesp: ineffective, too expensive, and dangerous?

  1. This isn’t new either – it’s been going on for at least 30 years. One example is if you’re admitted to hospital you’ll get an I.V. of some sort stuck in you whether you need it or not – it’s all to do with kickbacks and other immoral ‘incentives’. That sort of thing is one of the reasons my dad quit the civilian hospital scene.

  2. “I’m looking forward to the input of Science Based Medicine bloggers on this”

    Why the hell do you want that septic tank of crackpots on it? What it needs is an objective audit of the evidence, not more psuedo science spin!

  3. 50 years ago we had a sort of commitment for the health of humans. There was no thought of Wall Street and share values. Vitamins, minerals, antibiotics were the order of the day and they stood the test of times. Today it is the INTELLECTUAL DISHONESTY THAT IS SUBJECTED TO PATENTING.The goal is $billions and a global looting by all the pharma companies. Now our health is in the hands of God and good genes of our fore-fathers.

  4. The sun set and “Hours later, Lenox was dead.” Correlation is still not causation. Did he die from a known side effect of the drug? Did he die of the cancer? Did he have a heart attack? That is a crap article. It gives no concrete information, only supposition.

  5. My practioners over prescribed epogen and/or procrit for the whole two years I was on dialysis. Only now am I realizing what was going on. I was being prescribed and the scripts were being filled for amounts way and above what I was actually using. I still have mutliple vials of the stuff from the time I was on it (2008 – 2010). All the time trusting the practioners “knew what they were doing”. And boy did they ! They were bilking Medicare and/or my private insurance out of $1,000’s of dollars. How’s that for concrete information, Gwen ? And how ’bout you wonderstuff, am I some “crackpot spinning pseudo science” ? Have either of you the gumption to respond ?

  6. The black box side effects are true. My dad is in the hospital as I write this. He is 89 and has anemia a symptom of mds, he also had a heart valve problem. Dr. Sandeep Thapper used high doses of procrit on him for 7 months. He developed clots in his lungs, his heart was damaged further, and his liver was inflamed from the pain killer he took for the extreme joint pain it caused. When he complained of chest pressure he was given another shot. Presently he is so weak he cannot walk but lucky to have survived the procrit death. Last summer he drove his boat, the golf cart and cut an acre of lawn. Do not use procrit off label. He frightened my 87 year old mother of transfusions…he got angry when I would not allow my father to get a 412-400-7665. It was 7 months of hell.

  7. The black box side effects are true. My dad is in the hospital as I write this. He is 89 and has anemia a symptom of mds, he also had a heart valve problem. Dr. Sandeep Thapper used high doses of procrit on him for 7 months. He developed clots in his lungs, his heart was damaged further, and his liver was inflamed from the pain killer he took for the extreme joint pain it caused. When he complained of chest pressure he was given another shot. Presently he is so weak he cannot walk but lucky to have survived the procrit death. Last summer he drove his boat, the golf cart and cut an acre of lawn. Do not use procrit off label. He frightened my 87 year old mother of transfusions…he got angry when I would not allow my father to get a shot. It was 7 months of hell. He just had his second transfusion and did great! His road back will be long!

  8. Good article. It is rather unfortunate that over the last 10 years, the travel industry has had to tackle terrorism, SARS, tsunamis, bird flu virus, swine flu, as well as first ever real global recession. Through it all the industry has really proven to be effective, resilient plus dynamic, finding new methods to deal with misfortune. There are continually fresh complications and chance to which the field must all over again adapt and react.

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