WASHINGTON—In the wake of a number of regulatory and payment changes in ESRD care, nephrologists are changing their behavior in anemia management. This is evident in the drop in prescribed epoetin doses and hemoglobin levels in dialysis patients, according to the latest report from the Dialysis Outcomes and Practice Patterns Study (DOPPS).
The biggest change came In January 2011, when the Centers for Medicare & Medicaid Services (CMS) launched a new Prospective Payment System (PPS) with the intent to control dialysis costs through bundled payments. And in June 2011, the FDA approved revised prescribing information for erythropoiesis-stimulating agents (ESAs), used to treat anemia in most dialysis patients.
Previously, the label recommended a hemoglobin target range of 10-12 g/dL. The June 2011 update removed the target range, advising instead to start ESA therapy for dialysis patients at hemoglobin less than 10 g/dL, and to reduce or interrupt the dose when the hemoglobin approaches or exceeds 11 g/dL.
The report numbers come from the DOPPS Practice Monitor (DPM), which provides up-to-date trends in clinical care as the new Prospective Payment System (PPS) for renal dialysis services, which were implemented in January.
The DPM reports represent data in the form of more than 800 regularly updated charts, figures, and data tables. The DPM provides comparisons and trends over time for the United States as a whole, using weighting techniques, and among patient groups and facility types.
DPM data are aggregated across dialysis organizations and facilities. Aggregated trends may not reflect trends in individual dialysis organizations or facilities, and are not intended to provide oversight of performance in individual dialysis organizations or facilities.
