Cancer-related anemia: When dollars and cents - Not science - Dictate treatment

In an increasingly cost-conscious clinical environment, practitioners may be reluctant to prescribe erythropoietic agents for patients with mild anemia unless reimbursement guidelines are changed. In our institution, reimbursement requirements force us to wait for hemoglobin levels to fall to < 10 g/dL before initiating treatment with this mainstay of anemia therapy. These requirements often result in delayed treatment, which is clearly unacceptable, particularly when compared with reimbursement regulations in neighboring states. This article addresses the appropriate timing of intervention with erythropoietic therapy, the optimization of schedule and dose, and their impact on overall quality of life.