ASN statement: Secretary Azar’s speech on HHS-wide comprehensive kidney strategy

On Monday March 4th, Secretary Alex M. Azar II delivered a speech at the 6th Annual Kidney Patient Summit outlining both KidneyX and the strategic pillars of establishing an HHS-wide approach to comprehensive kidney care. ASN released a statement from ASN President Mark E. Rosenberg, MD, FASN, congratulating Secretary Azar and HHS on implementing this bold plan to better serve kidney disease patients and confirming ASN’s commitment to work together to achieve this goal.

ASN believes that Secretary Azar’s tripartite strategy, focused on preventing kidney diseases by catalyzing innovation in health care delivery and therapeutics, expanding alternatives to in-center dialysis, and increasing the availability of organs for kidney transplantation, will significantly improve the lives of those Americans affected by kidney diseases. The Secretary understands the urgent need to bring higher quality care to patients. He experienced it firsthand when his father had kidney failure, underwent dialysis, and then fortunately received a kidney transplant. ASN commends the Secretary and this administration for acknowledging that the current state of care for kidney patients is unacceptable and that complex barriers inhibit innovation—and for developing a visionary strategy to change that reality.    

During his speech, HHS Secretary Azar said that “as we learn more about kidney disease, we will examine ways to help spur drug development to help prevent or slow the condition. Shifting our reimbursements so that we’re actually paying to prevent kidney failure, rather than just paying to treat it, will help drive research in this area as well. There is a final advantage to better identification of kidney disease. Earlier detection means we have more time to educate patients, help them make informed choices about their treatment options, and prepare them for treating kidney failure as they wish—if and when that becomes necessary. This extra time allows an optimal start for treatment, whether that’s a pre-emptive transplant without dialysis, starting home dialysis with a functioning catheter, or starting peritoneal dialysis with a safe, permanent access. In other words, better prevention and detection efforts will help expand options for patients, that second focus I mentioned”.

He continued, “[t]oday, 88 percent of Americans with end-stage renal disease start treatment with center-based dialysis. Just 12 percent start treatment at home with hemodialysis or peritoneal dialysis. This is the complete opposite of the situation in some of our peer nations, including Hong Kong, where more than 80 percent of patients benefit from some form of in-home dialysis. Improving this situation dramatically, as we ought to do, will mean examining the payment incentives in our programs today, while expanding access to new technologies”.

More than 40 million people in the United States are living with kidney diseases and 700,000 Americans have kidney failure. Additionally, Medicare costs topped more than $114 billion in managing kidney diseases in 2016, which accounts for 23% of all Medicare spending. Innovative solutions could result in better treatment and lower costs for all.

Within the ASN statement in response to the speech, Dr. Rosenberg stated that: “I am grateful for Secretary’s Azar’s commitment to bringing new therapies to patients through KidneyX, a partnership between HHS and ASN to accelerate innovation in the prevention, diagnosis, and treatment of kidney diseases. KidneyX stimulates the commercialization of new therapies and technologies, providing a catalyst for investment by the private market. By funding promising innovators through a series of prize competitions and de-risking the commercialization process by fostering coordination across HHS, KidneyX aims to create a sense of urgency within the private sector to improve the lives of Americans living with kidney diseases through product development. As Secretary Azar noted, KidneyX received 165 applications for its first prize competition, Redesign Dialysis Phase 1, showing “what a prize competition can drive in an otherwise neglected investment space.”

“ASN welcomes Secretary Azar’s support of many of its long-held priorities in kidney research, care, and innovation, including the Kidney Precision Medicine Project, KidneyX, care models that go upstream to include individuals with kidney disease stages 4 and 5 and emphasize home dialysis and transplant, and taking bold steps to make sure we have enough kidneys to meet demand,” said Dr. Rosenberg.

To read the full statement from ASN, please visit the ASN website .

To see Secretary Azar’s full speech transcript, please visit the HHS website .