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« Food and Fuel | Main | Blogger Sentiment Poll: Profoundly Broken »

January 29, 2007



Bill - I listened to a conference call discussing the CHOIR results last November, and I personally reviewed the data from the study. Once again, this is necessary or one is likely to over-react.

Mark Schonebaum put the worst case effect (which he called unlikely) at 2% of total revenues. This is based on 45% of patients getting a 25% dose reduction.

Here are the facts behind the study:

Doctors have hemoglobin targets for patients, targets measured in mg/dl. The study was testing the recommendations of the National Kidney Foundation for a target level of 11-13 mg instead of the FDA approved 10-12. Medicare currently sets 13 mg as the top end for reimbursement. Doctors cannot hit the targets exactly. There is also a tendency to target higher in the sickest patients, which may have affected the result

The CHOIR authors recommended 11-12 as the range instead of 11-13. This is likely to have a very marginal effect on average dose per patient, while the number of patients is growing rapidly.

William Comcowich

You, Cramer, and most everyone else seems to be forgetting the earlier study that the Amgen drug is being given in too high a dose in kidney dialysis patients. As those study results percolate down to the clinical levels and gain traction, physicians will almost certainly start reducing doses. Cut the dose by 25% and you've got a serious earnings problem. It seems to me that is what is holding the stock back (and rightly so) -- not the Aranesp study in chemotherapy patients.

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