January 11, 2005

Dear RenalWEB Readers,

The year 2005 marks my 30th year of working in dialysis and nephrology. For the last six years, I have been reporting the news of the dialysis industry on RenalWEB. Up to this time, RenalWEB has played the role of editors, selecting information and stories of interest to the dialysis community from hundred of web sites and news agencies.

Now, I feel there is a bigger and more important story that must be told about the direction of care of kidney disease patients. This story will likely never be reported by the national press unless we start reporting it here.

This is the story of "Amgen Nephrology" vs. "Real Nephrology".

This is the story of how a government-granted drug monopoly that generates billions of profit each year changed the research priorities of many in the medical specialty of nephrology. It is how many of nephrology's best and brightest now work supporting research and clinical practices that feed the "Amgen Nephrology" profit streams. And it is how billions of Medicare dollars end up supporting a form of nephrology that better meets a drug company's strategic plans than the long-term medical needs of more than 300,000 Americans on dialysis.

Amgen has tremendous influence in the dialysis and nephrology community. With their monopoly on EPO, they have billions of dollars in profit available for discretionary use. All the major nephrology professional and patient organizations accept sponsorship money from Amgen. Study after study on EPO use is funded by Amgen, with top nephrologists listed as authors. It creates an atmosphere of complacency, with few willing to criticize the source that delivers needed dollars.

The publication of the book, The $800 Million Pill: The Truth Behind the Cost of New Drugs by Merrill Goozner, has lifted the veil off the self-serving practices and the millions of wasted research dollars seen in private sector drug development. I would urge all of you to read the related articles on this page.

What is needed by the 300,000 Americans now on dialysis and the hundreds of thousands with chronic kidney disease is a cure for kidney diseases. When the U.S. government agreed to fund dialysis treatment care in 1972, it was hoped that many of these patients would return to the workforce. With changing demographics, it is obvious now that this will not happen. Kidney transplants are falling woefully behind the need. U.S. government spending on dialysis now accounts for over 5% of the Medicare budget and is growing steadily every year. Only a cure for kidney diseases is going to solve this problem.

I believe that every dialysis patient in the country would be willing to sign a petition that requests federal legislators to reduce its Medicare EPO payments to Amgen and to redirect this money to finding cures for kidney diseases. This would generate hundreds of millions for this research. And - Amgen could still make tens of billions of profits in the coming decade with its monopoly/patent on EPO.

RenalWEB is now making this story a permanent feature on RenalWEB for the coming year. Details, facts, supporting information, and financial analyses will be coming. With Medicare spending likely to be curtailed during this session of Congress, the dialysis community and the pharmaceutical industry will both have to defend their needs. Amgen obviously has tremendous lobbying capabilities. Hopefully, facts and common sense can influence legislators to spend these billions of tax dollars more wisely.

If you have information or ideas that would shed more light on this story, please contact me at renalweb@renalweb.com.

Gary Peterson

(Edited for HTML formatting only, December 2006)

This message has been edited. Last edited by: Gary Peterson,