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Doctors reap huge payments for prescribing anemia drugs

NEW YORK -- Two of the world's largest drug companies are paying hundreds of millions of dollars to doctors in return for giving their patients anemia medicines, which regulators now say may be unsafe at commonly used doses.

The payments are legal, but very few people are aware of their size. Critics, including prominent cancer and kidney doctors, say the payments give physicians an incentive to prescribe at levels that might increase risks of heart attacks or strokes.

Industry analysts estimate that such payments -- to cancer doctors and kidney dialysis centers -- total hundreds of millions of dollars a year and are an important source of profit for doctors and the centers. The payments have risen over the last several years, as the drug makers, Amgen and Johnson & Johnson, compete for market share and try to expand the overall business.

Neither drug maker has disclosed the total amount of the payments. But documents given to The New York Times show that at just one practice in the Pacific Northwest, a group of six cancer doctors received $2.7 million from Amgen for prescribing $9 million worth of the drugs last year.

Yesterday, the Food and Drug Administration added to concerns, in a report that suggested use of the drugs might need to be curtailed in cancer patients. The report, prepared by FDA staff scientists, said no evidence indicated the medicines either improved quality of life or extended survival, while several studies suggested the drugs can shorten life when used at high doses.

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