Surveyed Nephrologists Report Significant Declines in the Use of ESAs in Hemodialysis and Peritoneal Dialysis Patient Populations, Compared with a Year Ago

April 9, 2014

Interest in ZS-9 and Patiromer is High After Review of Respective Product Profiles, According to Findings from Decision Resources Group

BURLINGTON, Mass., April 9, 2014 /PRNewswire/ — Decision Resources Group (DRG) finds that surveyed nephrologists report significant declines in the use of erythropoiesis-stimulating agents (ESAs) in hemodialysis (HD) and peritoneal dialysis, while ESA use in stage 4 use has remained statistically flat and use in stage 3 has increased compared with Q1 2013.


Other key findings from the report entitled TreatmentTrends: Nephrology (US) Q1 2014:

    --  Nephrologist perception of biosimilars: The majority of surveyed
        nephrologists believe that biosimilars (in general and for epoetin alfa)
        are very similar or somewhat similar to their branded protein product
    --  Percentage of patients on oral iron: Six months from now, surveyed
        nephrologists expect oral iron use to increase in HD and remain
        statistically flat in peritoneal dialysis, stage 4 and stage 3.
    --  American Regent's Injectafer: This intravenous iron, which was approved
        in July 2013, has reached low single digit chronic kidney disease
        non-dialysis reported patient share.
    --  Rockwell Medical's Triferic (SFP): A New Drug Application has recently
        been submitted to the FDA and, compared with Q1 2013, mean familiarity
        with Triferic, an iron compound that is delivered to HD patients via the
        dialysate, has significantly increased.
    --  Need for new therapies: The greatest perceived need for new therapies
        among a list of common areas in nephrology include: slowing the
        progression of kidney disease, diabetic nephropathy, acute kidney
        injury, polycystic kidney disease and glomerulonephritis. (A DRG report
        publishing later this year will cover the topic of diabetic
    --  Compliance: Based on common medications prescribed to patients with
        chronic kidney disease, surveyed nephrologists believe that pre-dialysis
        patients are most compliant with diuretics, significantly more than with
        iron therapies, renin inhibitors and phosphate binders.
    --  Bundling: General impressions on bundling are more positive since the
        bundling program started almost three years ago. In Q1 2014, about 29
        percent of nephrologists viewed bundling positively versus 12 percent in
        Q1 2011. Based on mean ratings, surveyed nephrologists are under the
        most pressure to restrict measurement of nonessential labs, to have
        more-stringent hemoglobin targets resulting in less ESA use and to use
        more iron at the expense of ESAs.

Comments from Decision Resources Group Director Rob Dubman:

    --  "It is not surprising that nephrologists are reporting continued
        dialysis declines in the use of ESAs, because we have observed this in
        our ChartTrends Renal Anemia series as well, which are studies of
        nephrologists submitting information from patient charts."
    --  "In terms of the renal pipeline, surveyed nephrologists' perceptions of
        ZS Pharma's ZS-9 and Relypsa's patiromer are both high after reviewing
        their product profiles. These are late-stage agents in development for
        the treatment of hyperkalemia. This finding is in line with the fact
        that this study also found that the need for new hyperkalemia treatment
        options was rated a 6.9 on a scale of 1-10, with 10 being a high need
        for an improved therapy."

About Decision Resources Group

Decision Resources Group offers best-in-class, high-value information and insights on critical issues within the healthcare industry. Clients rely on this analysis and data to make informed decisions. Find out more at www.DecisionResourcesGroup.com.

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For more information, contact:

Decision Resources Group

Christopher Comfort



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