the vast majority of CKD and dialysis patients, a decision that seems primarily driven by cost / reimbursement. Familiarity with Genzyme's Renagel is high, as are perceptions of its performance on the most important phosphate binder attributes, but use of the product tends to be limited to second line therapy. Current share for Shire's Fosrenol is relatively low but Nephrologists project a significant increase in use to close to 10% market share in the dialysis setting in the next six months, with decreases projected for both calcium-based binders and Renagel. Current use of FMC's PhosLo is also low, but Nephrologists expect increases in use among both dialysis and CKD patients in the next six months. Calcium carbonate, however, is expected to remain the go to calcium-based binder with approximately 90% of the calcium business.
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