As
2020 gets underway, the federal government has set its sights on
bringing innovation to an area of health that affects one in seven
Americans and costs the government more than NASA and the Department of
Commerce combined, yet hasn’t seen major innovation since the 1970s.
That
area is kidney disease. Both HHS Chief Technology Officer Ed Simcox and
HHS Deputy Secretary Eric Hargan addressed the topic at separate events
in San Francisco this week, and neither minced words when describing
the enormity of the problem — or the lack of real movement on it.
Kidney disease: A $35 billion innovation black hole
“If
you brought a patient on dialysis from 1978 forward in time 40 years,
how different would that experience be?” Hargan asked a crowd of
innovators at the Health 2.0 VentureConnect event on Monday night. “Not
very different at all, in fact. There’d be a flat screen TV to watch.
There’d be an iPhone to read instead of a pile of magazines. Probably
you’d have a better Lay-Z-Boy to sit in. But there would probably be
nothing fundamentally different about the experience.”
In
2019, as in 1972 when Richard Nixon signed the End-Stage Renal Disease
Bill, kidney disease therapy mostly means two things: dialysis, an
expensive, time-intensive and often lifelong in-patient procedure; and,
for a lucky few, transplantation of a donated kidney. And thanks to
Nixon’s signature, CMS remains obligated to pay for the former, to the
tune of $35 billion a year.
“It
was literally a two-paragraph, three-paragraph section in the Medicare
Act that basically said we'll take care of people with dialysis and
transplantation, all people forever,” Dr. John Sedor, chair of the
KidneyX steering committee, told MobiHealthNews in an interview late
last year. “And I think Congress at the time thought it was going to be
15,000 people and $100 million. Now it’s 600,000 people and $35
billion.”
There
has been some innovation over the years, but it has been incremental
rather than disruptive — a stark contrast to areas like cancer care or
HIV, where treatment looks dramatically different than it did in 1978.
“Dialysis
was a miracle therapy for its time, but it hasn’t changed in 60 years,”
Simcox said, speaking onstage at the Startup Health Festival alongside
Sara Holoubek, whose consultancy firm Luminary Labs is working with HHS
on kidney innovation. “The technology is exactly the same. We’ve made
the machines smaller, we’ve added filtration technology, but to get back
to your question, why is it that we don’t hear more about kidney
disease when it’s the ninth leading cause of death in the U.S.?”--> READ MORE
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