BioTrends Research Group, Inc. is pleased to announce the availability of its TreatmentTrends®: US Nephrology, EU Nephrology, and Canadian Nephrology publications. The reports are based on responses to online surveys completed by over 300 Nephrologists in the US, over 200 Nephrologists in Europe (UK, France, Germany, Italy and Spain) and 40 Nephrologists in Canada during November / December 2009.
A similar report on the renal anemia market in Latin America was published earlier this year. Collectively these syndicated reports provide comprehensive insight into how Nephrologists across the globe are utilizing ESAs and IV iron products to optimize the treatment of renal anemia.
In the anemia market, while use of ESAs has remained stable compared to the prior waves of research, changes are expected globally. Nephrologists in the US, Canada and Europe expect a decreased use of ESAs in chronic kidney disease - non dialysis (CKD-ND) patients in the coming months. This may be, at least in part, due to the disappointing results of Amgen's TREAT study which was published in the fourth quarter of 2009. Depending on the region, approximately one-third to one-half of Nephrologists expect the study to have a negative impact on their use of Amgen's Aranesp and in all markets, the majority of Nephrologists believe the study results are applicable to all ESAs. Ortho-Biotech's Procrit is the market leader in the US CKD-ND market, whereas Amgen's Aranesp holds this position outside of the US. In Europe, Roche's Mircera is making strides in the CKD-ND market and the trend is expected to continue according to future projections. Despite the expected increase, there are a number of attributes in which Nephrologists perceive Aranesp to outperform Mircera. In the US, Europe and Canada where long acting ESAs have been available, the need for new ESAs is generally ranked lower than other potential therapies, but in Latin America, the need for new ESAs, particularly the need for longer acting agents, is high. While not yet an issue in the US, in Europe, the availability of biosimilar ESAs provides an interesting added market dynamic. Acceptance of, familiarity with and use of biosimilar ESAs continues to be highest in Germany, although there is some use, particularly in hemodialysis patients, in other regions. Barriers to biosimilar ESA adoption center on general lack of familiarity/availability with the different biosimilar brands and safety concerns compared to reference brands. In the US market, while there are no anticipated shifts in ESA market share, the advent of the dialysis bundled payment system is likely to negatively impact the overall use of ESAs in the dialysis setting when it is implemented in 2011.
The IV iron market is expected to be positively impacted by the decreased use of ESAs. Already in the US, use of IV iron has significantly increased in hemodialysis (HD), peritoneal dialysis (PD) and CKD-ND patients compared to the previous year, and significant increases are expected in PD and CKD-ND patients in the next three months. The availability of AMAG's Feraheme in the US may also have an impact on increased use of IV iron, particularly among PD and CKD-ND patients as Nephrologists perceive this product to provide convenience in iron administration. Should it come to market, Rockwell Medical's Soluble Ferric Pyrophosphate (also known as dialysate iron) could alter the hemodialysis iron market. More than 50% of Nephrologists report a high interest in the product after reviewing a description and a number report a high likelihood to use the product if it results in lower ESA costs or lower supply costs compared to IV iron. In the near future, Nephrologists project increases of Galenica's Ferinject (ferric carboxymaltose) in many European markets and Feraheme in the US market, however Venofer and Ferrlecit are expected to retain the global market share leader positions.