Chronic Kidney Disease Patients Receiving Less ESA Therapy For Anemia Interview with:
Dennis J. Cotter
Medical Technology and Practice Patterns Institute, Inc.
Bethesda, MD 20816

Medical Research: What are the main findings of the study?

Answer: This is the first study to document anemia management practice patterns among predialysis CKD patients before and after publication of TREAT. Using a retrospective observational design based on a large US health plan database with over 1.2 million claims for predialysis CKD stage 3 and 4 patients, we report 4 main study findings.

1) For CKD stage 3 patients, the proportion prescribed ESA therapy declined from 17% pre-TREAT to 11% post-TREAT (a 38% decline) and for CKD stage 4 patients, from 34% to 27% (a 22% decline).

2) Prescribing of ESA therapy was declining even before TREAT, but the decline accelerated in the post-TREAT period.

3) ESA prescribing declined after TREAT regardless of anemia status; among patients with hemoglobin <10 g/dL, only 25% of stage 3 and 33% of stage 4 CKD were prescribed ESAs two years after TREAT, a notable 50% decline.

4) After adjusting for all covariates, the probability of prescribing ESAs was 35% less during a two year period after vs. before TREAT publication.
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