ASH Briefs Congressional Staff on ESA Guideline Update

October 23, 2007 – The American Society of Hematology briefed congressional health staff on Capitol Hill about the ASH-ASCO 2007 Clinical Practice Guideline Update on the Use of Epoetin and Darbepoetin.

ASH Executive Committee members Samuel Silver, MD, PhD; J. Douglas Rizzo, MD, ASH Co-chair of the Guidelines Panel and Associate Professor of Medicine, Medical College of Wisconsin; and Joseph Bailes, MD, ASCO Government Relations Council, discussed the effects of Medicare’s recent national coverage decision concerning erythropoiesis-stimulating agents (ESAs) on patients and clinicians and advocated for CMS reopening its coverage policy.

ASH has taken a leadership position on the ESA debate. The updated clinical practice guideline released yesterday includes a different interpretation of the evidence than Medicare. One key difference is that ASH recommends that patients with hemoglobin levels between 10 and 12 g/dL continue to be treated, while lowering the dosage when the hemoglobin rises above 11 g/dL. The Medicare policy restricts treatment once the hemoglobin is at 10 g/dL. ASH has urged Medicare to reopen and revise its coverage policy and has sent the updated guidelines to Medicare in the hope that it will revise the contentious part of the coverage policy.

The policy continues to be controversial and has prompted letters from 235 congressman and 52 senators, in addition to 2,600 comments on the ruling. ASH hopes that the guideline update will prompt Medicare to take action without having a congressional mandate.

The updated ESA guideline is posted as a First Edition paper on the Web site of ASH’s scientific journal, Blood (www.bloodjournal.org). In addition, the recommendations will be published in print in Blood on December 1.

Guideline update

Briefing materials for the Congress

Follow up on questions about ESAs