As the Center for Medicare and Medicaid Services moves toward limiting reimbursement for EPO drugs, Amgen and Johnson & Johnson are fighting back. Following the FDA, which recently added Black Box warnings to Aranesp, Epogen and Procrit, CMS worries the anemia meds can do more harm than good in cancer patients. Studies have shown the meds didn’t improve quality of life or extend survival, and can shorten lives when used at high doses.

But as Merrill Goozner writes on his blog today, Kent Conrad (D-SD) and Thad Cochran (R-MS) circulated a letter on Capitol Hill this week for other senators to sign, and it “clearly echoed talking points written by Amgen and J&J lobbyists….Similar letters have been sent to CMS by the American Society of Clinical Oncologists and the Community Oncology Alliance, whose members earn large profits from infusing patients with EPO in their offices…

“The letter from the senators urged CMS to ‘carefully consider the public health consequences of this proposed coverage decision,’ and warned that the CMS proposal will raise demand for transfusions from the nation’s limited blood supply and negatively affect the quality of life of the nation’s cancer patients.”

Then Goozner, who directs the Integrity in Science project, notes that “the emerging data that these drugs as currently used are probably killing people didn’t get mentioned in the letter. Indeed, the fact that EPO use in cancer patients is largely off-label and may be ‘inappropriate’ doesn’t appear until the fifth paragraph of the senators’ 7-paragraph letter, and even then it is raised as part of these senators’ admonition to CMS’s leaders that the agency’s safety concerns should not be used to limit patients’ access to ‘appropriate care.’

The drugmakers have every right to earn profits and lobby Washington. That’s not the issue, though. As Goozner concludes: “The last thing CMS needs is pressure from Capitol Hill to roll back the larger intent of the proposed payment policy. What the agency needs instead is legislative support for its efforts to help doctors obey the initial injunction of all medical practice – “ ‘First, do no harm.’ ”