On shaky ground

Aksys Ltd. has reported its first-quarter financial results. Earnings were about $500,000, but losses were $9 million. Aksys has never had a profitable quarter.

The 11-year-old firm claims 126 patients are using the PHD.

I don’t generally look that closely at corporate financials, but instead look at the product the company is marketing. However, your message made me want to check out what else was reported by the company and others.

First, you can’t just look at how long a company has been in business when it makes equipment that must be FDA approved. Aksys didn’t get FDA approval until March 27, 2002. The company began marketing and selling its machine in the 3rd quarter of 2002…a little over 2 years ago. You’re right that Aksys reports 126 patients are using the Aksys PHD at the end of the first quarter of 2005.

A press release on the Aksys website at www.aksys.com/press/20050509.asp also reports:
– Aksys now has partnerships with 45 dialysis programs.
– Aksys has placed PHD machines in 13 new clinics in the first quarter of 2005.
– Aksys has doubled its sales force.
– Aksys received Frost & Sullivan’s 2005 Medical Devices “Enabling Technology of the Year” Award.

Because Aksys rents and sells machines, it’s important to know that the revenue from sales of machines is reported when the machine is installed but revenue from rentals of machines is reported over the life of the rental agreement. Aksys reports that more rental units were placed in the first quarter of 2005 than in 2004. I’m not an expert on this, but it seems to me that when a dialysis clinic rents a machine, it is easier to return an older machine for an upgraded one or to offer patients the option to switch from machine to machine compared to when a clinic purchases a machine.

On Yahoo, it also says:
“Aksys Ltd’s Corporate Governance Quotient (CGQ®) as of 1-May-05 is better than 25.4% of Russell 3000 companies and 31.9% of Health Care Equipment & Services companies.”

Finally, having just returned from the National Kidney Foundation’s spring clinical meetings in Washington, DC, if booth traffic is any indication of company potential, there were always people (patients and professionals) in the booth looking at the Aksys PHD.

mmiller your interest in home dialysis and daily dialysis seems to be from the point of view of an investor/speculator. What is your point?

I am one of the 126 patients on the Aksys PHD machine, I love it, it allows me to schedule my dialysis around my life rather than scheduleing my life around dialysis. I’m not worried about the companys future, the PHD System has only been out for about 2 years, when more and more patients hear about it, more and more machines will be sold or rented. The problem lies in the big money contracts that companys like Devita sign with manufactures. Those contracts keep alot of patients in those centers from ever hearing about Aksys or NxStage or any machine that they don’t have listed on the contract. I think it’s a travesty, centers should offer a wide range of home hemo machines to fit the individual patients needs. Not just what they are getting money to push in that particular center.
John L

Hi John,

I think the issue of patients not being aware of home dialysis in general–PD and home hemo–is much more complex than just contracts signed for certain machines. Dialysis is a SYSTEM, and clinics have chairs that they want to fill. The easiest thing, from a system perspective, is to put a patient in a chair. It’s MUCH more challenging and time-consuming to:
– Teach people about all the options
– Set up a home visit to be sure that home treatment is appropriate
– Assess the patient and partner to see if they will be able to learn what they need to know
– Conduct training and be sure it’s “taken” (while losing money, because Medicare reimburses only an extra $20/DAY of training)

Of course, I would also argue that it’s much more rewarding to take those steps and to help patients become empowered and have full lives! :smiley:

I truly don’t think the issue is really so much which machine patients have access to (though I agree with you that the more choices the better). Rather, it’s more about which treatment options they have access to. Current Medicare regulations don’t require clinics to tell patients about any options they don’t offer themselves. This was one comment the Medical Education Institute made on the Conditions for Coverage–patients should have the right to be told about ALL forms of dialysis and where they can get them. Far too many patients begin in-center hemo without ever knowing there are other choices, and each year thousands of working-age patients give up their jobs and go on disability, probably permanently, when some of them wouldn’t have to if they felt better and had access to work-friendly home treatments. Once patients find out that PD or home hemo exist, THEN we can worry about which machines they can use.

Well put, I would like to see Medicare better educate patients. I have been through this myself, I had to go find a home system that fit my life, my center was horrible, and would not help me. I want to make it easier for other patients who may want something other than in-center hemo. I am trying to get into advocacy and have been writing my Senators. Maybe if I yell loud enough and at the right people something can get done. I like the article about S. 635 on this site, it’s a good start.
John L

Medicare has a new patient packet that it sends to every new patient it learns about from dialysis clinics. Unfortunately, patients get the packet 2-3 months after they start dialysis…which may be after they’ve gotten settled into in-center hemodialysis and when they don’t want to “rock the boat.” The longer patients stay on in-center hemo, the more depressed and dependent on staff they seem to become. I think doctors need to start informing patients about their treatment options for kidney failure long before it occurs. There are tools to help them do this…like this website. All they have to do is find out if patients have Internet access and either give them the web address or print copies of the information to share with patients.

I’m very happy to hear that you’re interested in advocating for improved quality of care and access to home dialysis. You might want to contact Lori Hartwell, a long-term patient, who established the Renal Support Network (www.renalnetwork.org). She is building an advocacy network of patient advocates from across the country.

In addition to S 635 that was introduced in the Senate, the same bill was introduced in the House as HR 1298. If you haven’t already done so, write both your senators and your representative from Home Dialysis Central’s legislative action center to tell them how important it is that patients have access to home dialysis treatment options. Tell everyone you know about this site that can help them write their elected officials very painlessly. Keep an eye out on Home Dialysis Central for information about a daily dialysis bill that we hope will be introduced in the next few months.

This is something that I am very psasionate about, I have contacted both my Senators, and I have been in contact with Ms Hartwell. I am doing all I can at the time, but I want to do more.
John L