June's issue of Community Oncology explores the debate over the use of ESAs (erythropoiesis-stimulating agents).

ESAs are anemia drugs that increase the level of oxygen-carrying red blood cells and the protein hemoglobin. They are used by many cancer patients to fight fatigue and anemia, which occur either as a direct result of their disease or their treatments. The ESAs include EPO (epoetin alfa, or Procrit) and DARB (darbepoetin alfa, or Aranesp).

New data has come out on potentially dangerous side effects of these drugs including blood clots. These drugs are also very costly and some critics have accused oncologists of overprescribing them, swayed by rebates from pharmaceutical companies.

Medicare is currently reviewing their reimbursement policy for the use of these drugs to possibly limit coverage. According to David H. Henry, MD, FACP, and editor of Commmunity Oncology, if this new reimbursement policy is enacted, it would eliminate the use of almost 90% of ESAs in oncology.