Blacks and Anemia Medications
by Lee H. Walker (bio)
Have you heard federal regulators want to cut back on the amount the government will pay for certain drugs for cancer patients and people on kidney dialysis?
Any changes in how the government regulates health care assistance should be of particular concern to the black community, since blacks disproportionally rely on federal programs such as Medicare to pay for their prescription drugs. Blacks, for example, make up 13 percent of the general population but comprise nearly 40 percent of dialysis patients.
The drugs currently in question are related to anemia. They stimulate the production of red-blood cells, the loss of which often results from cancer chemotherapy and kidney disease. As a consequence, cancer victims and people on dialysis are the heaviest users of the drugs.
The most prescribed drugs of this type are Epogen and Aranesp, sold by Amgen, and Procrit, sold by Johnson & Johnson.
After reading about this in The Wall Street Journal and discussing it with a physician, my first conclusion was that it is difficult to talk honestly about the issue of racial disparity- even in a situation with life-and-death consequences.
Drug companies are being accused of playing the race card for talking about how restrictions on drug reimbursement will disproportionately affect blacks. But the facts are on the drug companies' side. Nobody is denying that blacks rely more on Medicare and undergo dialysis at higher rates than whites.
Some of us are undoubtedly a little embarrassed, since this controversy points out that too many blacks tend to live less healthy lifestyles than our parents or grandparents. To a degree, it reflects a lack of personal responsibility.
Obesity, however, goes beyond race and gender. Eating habits can be changed, helping reduce hypertension, diabetes and other related ailments. The latest survey from the Center for Disease Control says life expectancy in America hit a record high of almost 78 years. White males average 75 years, while black men average only 69 years. White females average 80 years, while black females average 76 years. This disparity points to the need to make improving black health a high priority.
But there's another side of the debate that's not getting the attention it deserves. The pressure to reduce prescriptions for these anemia drugs isn't coming from patients or their doctors. It's coming from the government. While overprescription worries are cited as the reason for regulating prescriptions, the fact that government spending on them is extremely high cannot be ignored. Professionals, such as the members of the American Society of Clinical Oncology, still fear Medicare's limitations may restrict "physicians' ability to provide the care they judge most appropriate for their patients."
As government pays for more medical expenses in the United States, don't be surprised by calls for price controls and rationing of drugs are becoming more common. The poor and the unhealthy, the people most reliant and with the least political clout, would be the first to be hurt by such budget-cutting efforts.
When our access to life-saving drugs and quality health care depends on government funding, those who decide what gets funded and what gets cut become immensely powerful. We would be much better off if those decisions were made by patients and their doctors instead of by Washington bureaucrats.
Government substituting its judgment for what patients and doctors think is best is a growing problem. New research shows that the substitution of generic drugs for Lipitor - the popular cholesterol-lowering medication - could be causing higher risk for heart attacks. Where did the pressure to replace Lipitor with generics come from? You guessed it - government agencies looking to save money.
How we pay for our health care does make a difference. Blacks have special reasons to pay attention to this debate, regardless of their political affiliation or income. Opposing restrictions on anemia drugs is a good place to start.
# # #
Lee H. Walker, a member of the Project 21 black leadership network, is president of The New Coalition for Economic & Social Change. Comments may be sent to email@example.com.
Published by The National Center for Public Policy Research. Reprints
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