According to the Medicare Advisory Payment Commission, the use of separately billable drugs administered during dialysis has increased throughout the 1990s and payments for these services represented about 41 percent of Medicare’s total payments to dialysis facilities in 2003. This raises questions as to whether dialysis patients and their advocates should be lobbying for legislation that would redirect some of these current ESRD Medicare pharmaceutical dollars to research, better utilizing these tax dollars instead to seek cures for kidney diseases and to fund kidney-related stem cell research.

(Next week, we'll run the numbers that would be generated by a 10-20% reduction in federal payments for EPO, as well as the likely lobbying actions and campaign contributions that would be involved.)

The $800 Million Pill suggests ways that the government's role in testing new medicines could be expanded to eliminate the private sector waste driving up the cost of existing drugs. Pharmaceutical firms should be compelled to refocus their human and financial resources on true medical innovation, author Merrill Goozner insists. This book is essential reading for everyone concerned about the politically charged topics of drug pricing, Medicare coverage, national health care, and the role of pharmaceutical companies in developing countries. (The University of California Press)

Related reviews, commentaries and articles:

• The American Prospect: The backlash against Big Pharma may have already begun
• New America Foundation: Why Americans believe they have to put up with pharmaceutical profiteering
• Bio IT World: The true cost of drug discovery
• San Diego Union-Tribune: A hard 'pill' to swallow
  
• On the Commons

  "Like all drug companies, Amgen claims that the high price of Epo is necessary to fund its search for innovative new drugs."

  Editor's Note: Use of EPO in dialysis centers has been the biggest source of profits that funds research at Amgen. It may be time for dialysis patients to demand that some of this money be redirected to seek cures for kidney failure.

  Be sure to read the last paragraph of the article. Had the paperwork been done, the patent for EPO would likely have belonged to the U.S. government.

• SiliconValley.com: Loophole boosts biotech profits

  "In Epogen's case, Amgen won as many as 12 extra years of protection beyond that first patent, which will keep the price high until 2016."

• Scientific American: The orphan drug backlash
• PowerPoint Presentation from The Earth Institute at Columbia University

• IndustryWeek named Amgen CEO Kevin Sharer CEO of the Year and

• Forbes magazine named Amgen Company of the Year.

Previous battles between dialysis providers and Amgen are detailed in these news summaries:

• EPOGEN® Wholesaler Acquisition Price Increase

• CMS Issues Final Outpatient Rule - Cuts Aranesp® Reimbursement

• EPO Price Increases