The Trump administration on Tuesday released a national kidney care plan that blames anticompetitive and burdensome actions for a lack of innovation in the treatment of kidney disease, and it calls for modernizing the rules that govern the field.
The Kidney Care National Plan, posted by the Office of the Assistant Secretary for Planning and Evaluation at the Department of Health and Human Services, describes that shortfall as "the structural outcome of anti-competitive and burdensome actions that have maintained the national crisis of kidney disease and kidney failure." Restoring vibrancy to kidney care, and with it better outcomes at lower cost, will require reviewing and modernizing the regulatory framework "to better encourage competition, innovation, and patient-centered care," the department's summary says. The office classifies the document as a strategic plan, one that identifies opportunities for policy reform and improvement across the department's work.
Shares of DaVita and Fresenius Medical Care, the leading dialysis providers in the United States, traded lower on Tuesday after the administration proposed freeing up the kidney care market for new entrants. DaVita fell more than 7 percent in New York, according to dpa-AFX, and Fresenius Medical Care, a German company whose business depends heavily on the United States, dropped 3.7 percent in after-hours trading on the Tradegate exchange compared with its close on Xetra.
The same wire report cited a first assessment from JPMorgan analyst David Adlington, who wrote that the plan contained a lot of rhetoric but few concrete measures. Adlington singled out the revival of a debate over financial support for patients, along with a greater use of transplants, as particularly concerning, and he kept his underweight rating on Fresenius Medical Care.
DaVita answered with a statement released Tuesday evening that paired broad agreement with a pointed objection. The company said it shares the administration's urgency and that the plan reflects many of its own priorities. Noting that 87 percent of adults with chronic kidney disease do not know they have it, DaVita said it agrees on the need to identify the disease earlier, slow its progression, expand patient choice and improve coordination of care.
"Where we differ is the suggestion that kidney care has lacked innovation or that scale stands in its way," the company said. DaVita argued that its size helps it invest in proprietary technology and extend advances in care to patients "more quickly and broadly," and it said it is in the middle of rapidly deploying a major clinical innovation across its centers that brings dialysis treatment "one step closer to the natural kidney."
On transplants, the company said progress has not come fast enough because of "the critical shortage of viable human organs," and it put the kidney transplant waiting list at roughly 90,000 Americans. DaVita also cautioned that efforts to prevent kidney disease "must not be conflated with the distinct imperative to deliver high-quality, lifesaving care to people who have already reached kidney failure." It closed by saying it looks forward to working with the administration to turn the plan's ambitions into meaningful progress for Americans with kidney disease.