Date:9/11/2008

en in charge of monitoring lab values and adjusting treatment based on protocols for both ESAs and IV iron. In CKD, however, Anemia Managers tend only to see the patients who Nephrologists deem are in need of anemia management. The nephrology office or CKD clinic is the most common place patients receive their ESA therapy. For patients who do not receive their ESA at the office, administration location is typically driven by geography or insurance. From a brand perspective, Amgen's Aranesp and Ortho-Biotech's Procrit continue to battle for market leadership in CKD. Anemia Managers tend to feel that Procrit has an advantage on tolerability, ease of dosing modifications, and reimbursement, whereas Aranesp has an advantage for patients who self-inject. IV iron is used with much less frequency in CKD patients compared to ESAs; however, Anemia Managers predict a significant increase in their use of IV iron in the next three months. Potential reasons include an increased focus by managed care on iron status to approve ESAs and restrictions on starting ESAs (often Hb less than or equal to 10g/dL). For CKD patients who do receive IV iron, most do so on a repletion basis, commonly 1000mg over five infusions. The most desired feature in a new IV iron product among Anemia Managers working with CKD patients is the ability to give larger doses at once to reduce the number of patient visits, a feature that AMAG Pharmaceuticals may be able to capitalize on with Ferumoxytol, an IV iron product currently under review by the FDA.

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BioTrends Research Group, Inc. (http://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 visit http://www.bio-tren
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SOURCE BioTrends Research Group, Inc. Copyright©2008 PR Newswire. All rights reserved

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