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Taxpayers Overpaying for Epogen

Filed August 13th, 2012 Laurie

According to an analysis of federal data, the U.S. health care system is paying far too much for a single anemia drug called Epogen thanks to Medicare, which overestimates its use by hundreds of millions of dollars each year. Medicare then reimburses hospitals and clinics the overpayment based on estimates, not the actual use of the drug.
Epogen had ranked some years as the most expensive drug to taxpayers through the Medicare system.

Medicare’s current estimates are based on Epogen usage from 2007 for dialysis treatments, but use of the drug has fallen by 25 percent since then, partly because of the FDA’s warnings about risks associated with the drug, and partly because Congress removed the financial incentives for clinics and hospitals to prescribe the drug.
Medicare, however, still reimburses health care providers as if the dosing levels haven’t changed.

The drug was approved by the FDA in 1989. Since that time, the purported benefits of Epogen have been found to be overstated. It has also been found to have dire health risks, including cancer and heart attacks.

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