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August 22/29, 2007

Epoetin Dosing and Dialysis Facility Ownership

Author Affiliations

Letters Section Editor: Robert M. Golub, MD, Senior Editor.

JAMA. 2007;298(8):861-863. doi:10.1001/jama.298.8.861

To the Editor: Anemia management in patients with chronic kidney disease has come under increasing scrutiny from the scientific community, Congress, the Food and Drug Administration, the Centers for Medicare & Medicaid Services, and the public. At issue is whether current utilization of the highly effective, but expensive, erythropoiesis-stimulating agents (ESAs) is driven primarily by clinical or by financial motives. The study by Dr Thamer and colleagues1 suggests the latter, and the Editorial by Dr Coyne2 challenges the integrity of nephrologists who manage this difficult and complex patient population.