Cancer is second-only to heart disease-as one of the leading causes of death in the United States. Unfortunately, some treatment protocols may be as dangerous as the disease if they are not properly administered. This reality was brought to light by a recent Columbia University Medical Center (CUMC) study published in the “Journal of Clinical Oncology.”
On August 1st, the reputable journal published findings from the CUMC team in which more than 21,000 Medicare beneficiaries’ records were analyzed. Reviewing data from 1995 to 2005, study subjects consisted of patients who were aged 65 and older, diagnosed with either breast, lung or colon cancer, and had at least one erythropoiesis-stimulating agent (ESA) and chemotherapy benefits claim.
ESA, used to treat anemia in patients receiving chemotherapy, may have been the focus of the study; however the CUMC team discovered that the therapy causes a number of safety and cost concerns.
Of the patient records analyzed, 24 percent (5,099) received ESAs for one week or less, which constituted misuse of the drug therapy. Another 7.6 percent (1,601) were prescribed the therapy in excess of 14 weeks, which was longer than the recommended treatment period noted on product labeling. Another 13.6 percent (2,876) of the patients received the treatment in the absence of chemotherapy, which was also inconsistent with product labeling. The CUMC study findings highlighted a number of issues, including inappropriate use of ESA, physician propensities to prescribe off-label, patient safety, and resource waste.
Recently the United States Food and Drug Administration (FDA) announced new dosing guidelines for ESAs when prescribed to patients with chronic kidney disease. The change was prompted by findings that ESAs increased the risks of adverse cardiovascular incidents such as stroke, blood clots and heart attack in these patients, potentially leading to medical malpractice claims.
ESA use increased 340 percent in the United States from 2001 to 2006. Considering that the National Institutes of Health reported that cancer cost the American public an estimated $263.8 billion in medical costs and lost productivity in 2010, ESA therapy costing the Medicare system an estimated $1 billion dollars each year is significant.
Cancer impacts millions of lives and patients rely on their doctors to know the risks certain drug therapies have on their life and health. The CUMC study proves that doctors need to be better educated on treatment interventions or their patients will suffer the consequences.