EPO–Why we need Efficacy and Comparison Studies

After 20 years on the market and tens of billions of dollar/year spent on erythropoietin-stimulating agents (ESA’s) a large study in the Journal of the National Cancer Institute (Dec 2,2009) will report:

  • “These agents were approved to reduce the risk of blood transfusions by 50 percent,” Hershman said. “There was absolutely no difference in the transfusion rate over the 10-year period from when these drugs hit the market,” she said. “The majority of patients are getting these drugs and receiving transfusions.” (emphasis Medicynic)
  • “The researchers found that 14.3 percent of patients receiving ESAs developed thromboembolism (deep vein thrombosis or pulmonary embolism) compared with 9.8 percent of those who did not receive an ESA.”
  • “ESAs stimulate red blood cell production and are intended to reduce the number of blood transfusions needed during chemotherapy. However, the rate of blood transfusions remained the same for both groups (22 percent). Survival in both groups was also similar, the researchers noted.”

Medicynical Note: These drugs (ESA’s) did not decrease the need for transfusion, did not improve outcomes, increase complications and cost us tens of billions of dollars/year.

When EPO came onto the market oncologists were skeptical of the benefit and were very slow in their acceptance of the drug. The manufacturers mounted an unprecedented, at the time, direct to consumer campaign focusing on fatigue and chemotherapy. It was remarkably successful in getting physicians to use their agent.

Can you guess why the U.S. is number 1 in health care expenditures, by a wide margin?

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