BioTrends Research Group, Inc. has released two new syndicated market research reports evaluating the nephrology market in Europe. The reports, TreatmentTrends®: Renal Anemia and TreatmentTrends®: Bone and Mineral Metabolism, are derived from the responses of over 200 European nephrologists polled in May and June, 2010 regarding their approach to managing renal anemia and bone and mineral disturbances in their dialysis and chronic kidney disease patients.
In the renal anemia market, European nephrologists report more conservative approaches to the use of erythropoiesis-stimulating agents (ESAs) following the release of the TREAT (Trial to Reduce Cardiovascular Events with Aranesp Therapy) study. A majority of nephrologists expect to be less aggressive with ESAs in their chronic kidney disease (non-dialysis) population and many also expect a corresponding increase in the use of intravenous iron. Biosimilar ESAs have seen the greatest uptake in the German dialysis market with nearly one-quarter of ESA treated dialysis patients now on a biosimilar agent. Increased brand competition among biosimilars was also noted in this wave of research.
The use of non-calcium phosphate binders continues to trend upward and while most nephrologists do still begin phosphate binder treatment with calcium based agents, in many countries more than half of the binder-treated dialysis patients are on either Genzyme's sevelamer or Shire's lanthanum. For a majority of nephrologists surveyed, phosphorus is viewed as being more important to manage than either calcium or parathyroid hormone (PTH), particularly among dialysis patients. Furthermore, hyperphosphatemia is perceived by the survey respondents to be the leading cause of calcification compared to a host of other factors.
Dialysis share for Amgen's Mimpara was flat compared to the prior period (December 2009), but nephrologists continue to report expected increases in their use of Mimpara in the next six months. The market in the United Kingdom appears to be the most constrained by costs associated with Mimpara, whereas other markets suggest that poor gastrointestinal tolerability is also major obstacle to Mimpara growth. Compared to the prior period, while the mean PTH at Mimpara initiation did decrease significantly, more than one-third of nephrologists still primarily choose Mimpara for the triple effect of lowering calcium, phosphorus and PTH – a perception that leads to the most clinically challenging patients being placed on Mimpara.
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