Why Do We Need Innovation?
There are nearly 500,000 dialysis patients in the United States, with around another 230,000 patients with ESRD who are not yet receiving dialysis. The number of patients continues to grow each year. Treating these patients costs the federal government about $34 billion per year. 1 Yet health outcomes for this population have not consistently improved over time and uptake of innovative therapies like home dialysis and transplant remain too low.
Dialysis patients need innovation, but the landscape has not been conducive to this over the last twenty years. In fact, dialysis services in the United States today look largely the same as they did even twenty years ago because there have been very few new medical devices approved in the ESRD space over the past two decades, as well as slow pharmacological innovation.
There are several barriers to meaningful innovation in kidney health. It can be difficult to develop new drugs to treat kidney disease given a lack of clinically relevant molecules to work on. 2 In addition, the medical community and by the general public do not view nephrology as an “innovative” field as compared to others, such as cardiology and oncology, which makes attracting new talent difficult. 3
However, above and beyond these concerns, most experts agree that the major reason for the lack of innovation in this space is inadequate Medicare policy that does little to incentivize manufacturer innovation. When payment for ESRD care was bundled in 2011, CMS incentivized efficiency over innovation. The focus on cost savings under the bundled payment system can discourage innovation. Further, innovation is not rewarded through the bundled payment system. Rather, this system rewards and prioritizes efficiency.