Our results suggest that the 2006 publication of a clinical trial demonstrating harm with targeting higher Hb levels [4] and the FDA’s issuance of a black box warning on the epoeitin label [7] led to relatively modest changes in anemia management as compared with the much sharper declines in Hb and EPO doses that were seen in 2010 after publication of another trial showing harm with higher Hb values [9] and CMS’s release of the final rule for a revised payment system [11]. The gene discussed is GSTM1; the disease is anemia.