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BioTrends Releases Quarterly TreatmentTrends(TM): Nephrology Report Highlighting Market Trends for Renal Anemia, Hyperphosphatemia, and Secondary Hyperparathyroidism

EXTON, Pa., July 25 /PRNewswire/ -- BioTrends Research Group, Inc. released its 10th quarterly Nephrology TreatmentTrends(TM) publication, a syndicated report offering comprehensive insight into the management of renal anemia and bone and mineral metabolism in Chronic Kidney Disease (CKD) and Dialysis. The report provides information from 182 US Nephrologists -- data were collected through an online survey fielded in June 2008.

In the renal anemia market, while the use of ESAs remains consistent in hemodialysis patients compared to the same quarter last year, for the second quarter in a row, Nephrologists report a significant decrease in the percent of Stage 3 and Stage 4 CKD patients treated with ESAs compared to the previous year. And, approximately one-third of Nephrologists report that their ESA use has decreased specifically due to managed care policies. While there have been no significant changes in market share year over year (Amgen's Epogen remains the market leader in dialysis and Ortho Biotech's Procrit and Amgen's Aranesp continue to battle for market leader position in CKD), there are indicators of brand switching, particularly related to office stocking and managed care reimbursement. Despite the decreased use of ESAs in CKD, Nephrologists do not expect any significant change in treatment prevalence with ESAs in the next three months.

Unlike the use of ESAs in CKD, the use of IV Iron has not changed significantly since last year -- but treatment prevalence with IV iron in CKD remains much lower than treatment prevalence with ESAs. In part, this seems related to the fact that very few Nephrologists stock IV iron (36% compared to the 73% who stock ESAs) -- primary reasons for not stocking IV iron are "limited staffing resources" and "logistics of buying and billing." While American Regent's Venofer continues to hold its position as market leader in both dialysis and CKD, the majority of Nephrologists continue to view Venofer and Watson's Ferrlecit as interchangeable. For those that do perceive the products to be differentiated, Venofer tends to have a perceived advantage on ease of administration in both dialysis and CKD. AMAG Pharmaceutical's Ferumoxytol could be commercially available by the end of the year. Those with higher familiarity of the product, feel it has a dosing and administration advantage.

In the phosphate binder market, the launch of Genzyme's Renvela is beginning to shift market share in both dialysis and CKD segments. While Renvela has primarily cannibalized Renagel share, overall sevelamer share in both dialysis and CKD has increased compared to the prior year. Despite sevelamer's increased share, for the first time, overall satisfaction among the various phosphate binders is highest for Shire's Fosrenol. Concern with lanthanum absorption has fallen in recent quarters and is of significantly less concern than calcium absorption. Both Fresenius Medical Care's PhosLo and calcium carbonate continue to be impacted by concerns with calcium, although calcium binders are expected to remain the preferred agents in CKD. In response to a product profile for ferric citrate (Keryx's Zerenex that is currently in development), interest is high, but this particular compound may have to overcome perceptions of GI tolerability issues.

In the treatment of secondary hyperparathyroidism, Abbott's Zemplar continues to dominate the Vitamin D market in dialysis with a 74% share. In the CKD market, calcitriol/Rocaltrol continues to be the leading agent with 42% of the treated patients, and unlike dialysis where brand exclusivity is common, in CKD less than 5% of Nephrologists prescribe Zemplar or Hectorol exclusively. The most important PTH Modifier attributes are "Improves Mortality", "Effectively Lowers PTH", "Supported by Clinical Data", and "Well-Tolerated". Zemplar and Hectorol receive significantly higher ratings than Amgen's Sensipar and Calcitriol on "Improves Mortality" and "Well-Tolerated" whereas Sensipar receives significantly higher ratings than all vitamin D products on "Efficacy". While Sensipar receives higher ratings than vitamin D products on a number of additional attributes, the product continues to be reserved for patients with extremely elevated PTH.

About BioTrends Research Group, Inc.

BioTrends Research Group, Inc. ( provides syndicated and custom market research to pharmaceutical manufacturers competing in clinically evolving, specialty pharmaceutical markets. For information on BioTrends publications and research capabilities, please contact us at (610) 363-3872 or

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SOURCE BioTrends Research Group, Inc.
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