In 2015, Looking Back with Regret

In ten or more years, I believe we in the medical community will look back at this era in end-stage renal disease (ESRD) and will feel regret for how misaligned our priorities and business ethics were. Looking back, I believe we will see over 400,000 of our citizens living a marginal existence, exhausted by the enormous financial and physiological demands of ESRD and dialysis treatments. At the same time, drug companies in the ESRD industry were squandering billions of dollars in “marketing” to the physicians of these patients and the dialysis clinic owners. Not unlike the Dred Scott Decision of 1857, we will likely see this as another example of the kind of corrupt systems that arise from institutions that are allowed to accumulate excessive wealth.

Everyone knows of the excesses associated with the expense accounts of these drug company representatives, but few are willing to speak out against it. These companies make so much gross profit on these drugs that they have to spend money furiously just to make the net profits look reasonable. I would ask the dialysis patients of this country to ask their nurses and doctors about the excessive and wasteful spending that they see.  Ask them about lavish corporate displays they see at the professional meetings. Ask them about the extravagant dinners, trips, “educational grants”, “educational meetings”, and other “donations” - all with little or no accountability. This kind of funding creates an ethical morass for everyone involved on so many levels and in so many areas.  

Wouldn't we all like to know how much one biotech company is spending on sales and marketing for a drug which they have a government-guaranteed monopoly for the next ten years. Much, if not most, of this money is coming from the Medicare budget for ESRD.  As patients and concerned citizens, you need to tell Congress that you want them to allocate some of this money for a competition to find a cure for kidney disease, instead of solely funding a wasteful system that only "treats" kidney disease.

As I look at the web sites of the nephrology-related professional associations and the leading kidney patient organization, I see that these IV drug companies are prominently listed as their biggest sponsors and benefactors. I don't know if these groups can advocate for such a project, considering the huge loss of money they would likely experience. Instead, there will have to be a grass-roots call for this kind of solution to ESRD and long-term dialysis.

Gary Peterson, RenalWEB
March 10, 2005