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BioTrends Releases TreatmentTrends(TM): US Nephrology, an Ongoing Syndicated Publication Providing Insight into Physician Perceptions and Management of Renal Anemia, Hyperphosphatemia, and Secondary Hyperparathyroidism
Date:1/12/2009

EXTON, Pa., Jan. 12 /PRNewswire/ -- BioTrends Research Group, Inc. released TreatmentTrends(TM): US Nephrology, a syndicated report based on online survey results from 305 Nephrologists in the US.

The renal anemia market continues to show signs of stabilization. While the percent of patients with Chronic Kidney Disease not on dialysis (CKD) on ESAs declined significantly compared to the same period last year, only a small percent of Nephrologists reported making any changes in the past three months in their use of ESAs. The most noteworthy upcoming changes in this market may come from the proposed bundling structure under which Nephrologists project shifts to subcutaneous dosing, less aggressive treatment of EPO hypo-responders, and increased focus on patients' iron status. The commercialization of new ESAs could also alter market dynamics in which Amgen's Epogen currently leads the dialysis market and Ortho Biotech's Procrit and Amgen's Aranesp virtually split the CKD market. Even though the perceived need for new ESA therapies is relatively low, ESAs with extended dosing intervals are desired in CKD and ESAs with less hemoglobin variability are desired in dialysis. And among those aware of Affymax's Hematide, currently in development, interest is high.

The IV iron market, on the other hand, is likely to see more changes in the near-term with the potential approval of AMAG's Feraheme (ferumoxytol), which could be commercially available in the first half of 2009. Although awareness of this product remains relatively low, significant increases in representative activity were reported this quarter. In the CKD market, oral iron continues to be the first line treatment of choice over IV iron, and rationale for this tends to center around convenience, a potential advantage for Feraheme due to its perceived dosing and administration benefits. Contrary to the CKD market, in dialysis, the majority of patients are on IV iron and Nephrologists report preferring a preventative strategy employing maintenance dosing to manage iron deficiency versus the reactive strategy in line with repletion dosing that is most common in CKD. Despite these differences, Nephrologists report optimistic projections for Feraheme in both the dialysis and CKD markets, drawing share from American Regent's/Fresenius Medical Care's Venofer and Watson's Ferrlecit.

Many potential new products are also on the horizon in the phosphate binder market, albeit longer term. New products will likely be welcome additions as Nephrologists report that over one-third of their patients are not well-controlled on currently available binders. A binder that could be given with less frequency (as opposed to every meal) would likely have a considerable impact on market dynamics as the largest group of Nephrologists report patient non-compliance due to the frequency with which current binders have to be taken as the main reason phosphorus is difficult to control in dialysis patients. A more near-term shift in market dynamics will likely come from the recent introduction of generic calcium acetate from Roxane Laboratories, as very few Nephrologists oppose the substitution of a generic for Fresenius Medical Care's PhosLo. Another recent market shift came with the introduction of Genzyme's Renvela in Q108. Although the growth of Renvela seems to be fueled by cannibalization of Renagel, Nephrologists expect increases in overall sevelamer share in both dialysis and CKD, as well as increases in Shire's Fosrenol, while continued shifts are expected away from calcium based binders.

The proposed bundling structure is also expected to greatly impact the Vitamin D market, with over 50% of Nephrologists reporting they would shift away from IV Vitamin D to oral Vitamin D as their first line choice in hemodialysis patients. Another change in this market may be in the use of Nutritional Vitamin D, with over one third of Nephrologists expecting to increase their use of Nutritional Vitamin D in dialysis patients and close to half expecting to increase their use in CKD patients in the next six months. Despite these expected changes, the market has been relatively stable from a market share perspective as Abbott's Zemplar continues to hold its position as the leader in the dialysis market and calcitriol continues to hold this position in CKD. Use of Amgen's Sensipar has also been relatively stable, although Nephrologists continue to report an expected increase in use across both dialysis and CKD patients.

About BioTrends Research Group, Inc.

BioTrends Research Group, Inc. (www.bio-trends.com) 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 www.bio-trends.com.

All company, brand, or product names contained in this document may be trademarks of their respective holders.

    Contact:
    Jennifer Robinson
    BioTrends Research Group, Inc.
    610-363-3872


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