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Remembering Gene Goldwasser: Discoverer Of EPO, A Cure For Anemia In Dialysis Patients

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Gene Goldwasser died last week. He was 88, and he was my friend.

I wrote previously about a series of conversations I conducted with Gene and Rabbi A.J. Wolf a few years ago. I met Gene one spring day after calling to invite him to sit in on a class I was teaching to a small group of medical students about social issues in healthcare.

I’d read about him in a book called “The $800 Million Pill,” by Merrill Goozner. In the book, Goozner writes the story of Gene’s two-decade hunt to isolate the hormone erythropoietin (EPO).

Part of the story relates how Gene tried to interest traditional big pharma companies in his discovery, only to be brushed aside. Instead, Gene wound up sharing his discovery with what became Amgen. The company went on to make a windfall from recombinant production of the hormone and licensing it as a drug for patients with anemia and kidney failure. Read more »

*This blog post was originally published at ACP Internist*

A Gene For Surviving Dialysis

As a hospitalist physician of seven years and taking care of dialysis patients, I’ve come to the conclusion that a dialysis survival gene exists. I talked with a nephrologist the other day about dialysis survival. Here’s what he said:

“If you take all dialysis comers, every year 25% of them will die.”

There is a broad range of dialysis survival. A 94-year-old with severe COPD, CHF, and dementia will not have the same survival statistics as a healthy 27-year-old with acute interstitial nephritis. The protoplasm from which you begin with often times determines the dialysis survival.

There are many factors that determine dialysis survival statistics. Some of them include, age, race, weight, and even the length of the dialysis treatments. But no where have I seen reported the association of dialysis survival with Happy’s presumed dialysis surivival gene. Read more »

*This blog post was originally published at The Happy Hospitalist*

You Can Have An Organ Transplant, But You Can’t Have The Drugs You Need To Keep It Healthy?

kidney_unc_470pixIn a provocative analysis of a 30-year old Medicare coverage loophole, John Schall explained the following (at the Medicare Policy Summit event):

1. Medicare covers kidney transplants for patients with end stage renal disease (ESRD). Transplant patients, of course, require life-long immunosupressive drugs to keep their bodies from rejecting the new kidney.

2. Medicare only covers immunosupressive drugs for 36 months total. These drugs are too expensive for most patients to afford out-of-pocket.

3. Many kidney transplant patients covered by Medicare are unable to continue their immunosupression regimen after 36 months, and slowly go into organ rejection.

4. Once they have rejected their transplanted kidney, they are eligible to receive a new one, fully covered by Medicare, with (you guessed it) 36 months of immunosuppresive drug coverage to follow.

Wouldn’t it just be cheaper to cover immunosuppresive drugs for the lifetime of the patient who receives an organ transplant? Yes, and that’s what lobbyists have been arguing for 30 years now, without a change in the rules.

Government-run healthcare can have its challenges… and this is only the beginning.

Latest Interviews

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Latest Book Reviews

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The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

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Eat To Save Your Life: Another Half-True Diet Book

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