Unintended Consequence for Dialysis Patients as Drug Rule Changes
A patient waiting for a kidney got dialysis. More dialysis patients are getting blood transfusions.
A shift last year by the federal government in how it pays for drugs to treat dialysis patients may have had an unintended and potentially dire consequence, according to new research: a significant jump in blood transfusions for patients who now may not be getting enough of the medications.
The findings are seen by some experts as a stark illustration of how the government’s reimbursement policies can drive the practice of medicine.
The policy shift was intended to save money and protect patient health by correcting what federal regulators saw as a misguided financial incentive for dialysis centers to overprescribe anti-anemiadrugs.
Previously, the government had paid dialysis centers for these drugs separately from the actual blood-cleansing treatments, effectively encouraging their overuse. That created health hazards, as well, because the high red blood counts produced by overuse of the drugs carry a heightened risk of heart attack and stroke.
So the federal Medicare program, which covers the treatment of life-threatening renal conditions, regardless of a patient’s age, changed its payment system to reimburse for overall care, bundling together the cost of treatment and drugs. For the dialysis centers, that instantly transformed the expensive drugs from a profit center to a drain on profits.
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