Reply #4: A few notes about these drugs...

[Jamnt]

I'm a hospital pharmacist and have followed these drugs very closely in our population for about 2 years. I can say with experience that these drugs do not work that well. Just a few % of patients see improvement in their hemoglobin levels, many still require transfusions despite being on these drugs. I've given this feedback to our docs and our use has dropped off some, but the reps are busy people.

That being said, most of our docs know full well the dangers of trying to push the hemoglobin levels above 12, and none even try. It's a struggle to get them above 10 in most cases, even with higher doses. (The danger of increased heart attack risk and strokes is speculated to come from higher blood viscosities.) The FDA recently put out a med watch alert warning of this danger when results of a recent study became available.

The practice of kickbacks is deplorable, even more so in a setting where the drugs have questionable effectiveness. I have seen in our hospital system these drugs cost as much as 15% of our total drug budget. This is big pharma at its worst.