tag:blogger.com,1999:blog-9551150.post116137820832051326..comments2024-03-17T05:36:26.059-04:00Comments on Health Care Renewal: Guidelines in Whose Interest? - Amgen, Epoetin, Medicare, and Chronic Kidney DiseaseRoy M. Poses MDhttp://www.blogger.com/profile/00497209843184497847noreply@blogger.comBlogger6125tag:blogger.com,1999:blog-9551150.post-84678928422978411432010-02-04T18:14:12.777-05:002010-02-04T18:14:12.777-05:00I am a healthcare worker, and I can empathize with...I am a healthcare worker, and I can empathize with hemodialysis patients. My brother was 45 years old and took hemodialysis for 2 years. Although I understand your statement regarding quality of life, I will also not administer a medication to a patient whose Hgb or Hct levels exceed the recommended FDA guidelines for administrations. This is called off-label use, and in a court of law, I Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-58451938676785132672009-03-23T22:12:00.000-04:002009-03-23T22:12:00.000-04:00I am a hemodialysis patient. when my hematocrit g...I am a hemodialysis patient. when my hematocrit gets up to 39 the doctors slash my epogen in accordance with medicare guidelines. Then for a few months I feel lousy and drained as my hct goes down. What is better? keeping someone alive for a few more years, or giving them the ability to enjoy the life for a few more months?Anonymousnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-1161949007068109562006-10-27T07:36:00.000-04:002006-10-27T07:36:00.000-04:00In the case of chronic kidney disease, there is pu...In the case of chronic kidney disease, there is published evidence which demonstrates that both agents are safe and effective. In hemodialysis patients, a starting dose conversion factor of 200 units epoetin to 1 mg darbepoetin. This conversion is based on the mass of the peptide portion of each molecule. In contrast, randomized clinical trial data, demonstrate the ratio necessary to produce Luigihttps://www.blogger.com/profile/10608708443984784367noreply@blogger.comtag:blogger.com,1999:blog-9551150.post-1161446622372317002006-10-21T12:03:00.000-04:002006-10-21T12:03:00.000-04:00Excellent post. We need guidelines on what consti...Excellent post. We need guidelines on what constitutes a guideline, how systematic literature reviews are written, and what a consensus statement represents. I have seen all of these terms abused for their implications of fair use of evidence. <BR/><BR/>Then we need to make sure that such documents are assembled by experts in assessment of evidence who are agnostic about the particular subjectAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-1161438398592023932006-10-21T09:46:00.000-04:002006-10-21T09:46:00.000-04:00What I find interesting is the reference to Forbes...What I find interesting is the reference to Forbes's. In following hcrenewal I have been struck by the number of references to business journals. I find it troubling that the WSJ, Boston Globe, New York Times, and the popular press, are asking the questions, and researching the answers, to issues that should be first discussed in the medical community,<BR/><BR/>Steve LucasAnonymousnoreply@blogger.comtag:blogger.com,1999:blog-9551150.post-1161380943438711272006-10-20T17:49:00.000-04:002006-10-20T17:49:00.000-04:00I'm not sure what Medicare shells out for newer an...I'm not sure what Medicare shells out for newer antipsychotic medications (Zyprexa, Risperdal, Seroquel, etc.), but it must be several billion annually. This is analogous to the post here in that there is little evidence supporting their use over other less expensive meds. Granted, the old meds have their own problems as well, but at a price of 1-5% of the new meds, shouldn't we reconsider CL Psychhttps://www.blogger.com/profile/13990549972520745769noreply@blogger.com