Medicare’s Denial Of Coverage To Kidney Patients Could Be Just The Beginning

In September 2018, the Centers for Medicare & Medicaid Services (CMS) sent an email announcing that it would no longer cover Auryxia®. Auryxia® is an FDA approved medicine that treats iron deficiency anemia (anemia) for patients with chronic kidney disease (CKD) but who are not on dialysis.

People with CKD have damaged kidneys that no longer filter their blood properly. Currently, 30 million people in the U.S. are living with CKD, and for these patients, anemia is common. If left untreated, anemia increases the risks for cardiovascular disease, end-stage renal disease, and premature death. These patients also have increased hospitalization rates and lower overall quality of life. From a cost perspective, untreated anemia increases the annualized cost of CKD by nearly $29,000 per patient.

Even based on a cold cost-benefit analysis, simple arithmetic argues against dropping coverage of Auryxia®. The manufacturer’s label lists the starting dose for iron deficiency anemia in CKD cases at 1 tablet 3 times per day, while the average dosage in clinical trials was 5 tablets per day. Since a supply of two hundred 210 mg tablets costs around $1,200 according to Drugs.com, the annual cost of Auryxia® based on the price offered on drugs.com ranges between $6,570 -  $10,950. This does not account for Medicare Part D discounts, which are usually significant, but even without the savings, Medicare would reduce spending by treating anemia with Auryxia® compared to the costs associated with untreated anemia. --> READ MORE