BURLINGTON, Mass., Nov. 12, 2014 /PRNewswire/ -- Decision Resources Group finds that surveyed nephrologists expect hypoxia inducible factor-prolyl hydroxylase inhibitors (HIF-PHi) to capture share of their total prescriptions in both chronic kidney disease non-dialysis (CKD-ND) and dialysis patient populations, assuming that late stage clinical development therapies such as FibroGen/AstraZeneca/Astellas' roxadustat, Akebia's AKB-6548, and GlaxoSmithKline's GSK-1278863A are approved and available for the treatment of renal anemia by 2020. Physicians also anticipate more prescriptions for HIF-PHi if they are placed on a preferred tier versus a non-preferred tier in both CKD-ND and dialysis.
The U.S. Physician & Payer Forum report entitled Oral HIF-PH Inhibitors for the Treatment of Renal Anemia in CKD Non-Dialysis and Dialysis: How Will U.S. Physicians and Payers Respond to This Novel Class? is based on a survey of 101 nephrologists and 31 managed care organization (MCO) pharmacy directors and medical directors. Other key findings from the report include:
- Unmet need for erythropoiesis-stimulating agents (ESAs): Ninety percent of nephrologists believe there is some level of unmet need for ESAs, representing an opportunity for marketers of emerging agents.
- Inclusion of IV ESAs on the formulary: Surveyed MCO pharmacy directors and medical directors largely include ESAs on their formulary for the treatment of renal anemia, and the report notes differences between commercial and Medicare Advantage plans.
- Likelihood of prescribing biosimilar ESAs: Assuming FDA approval, nephrologists seem moderately likely to prescribe epoetin alfa biosimilars instead of branded ESAs.
- Key advantage of HIF-PHi in CKD-ND: According to more than 60 percent of mentions by nephrologists, oral route of administration is the greatest advantage of HIF-PHi in CKD-ND.
- Expected tier placement of ferric citrate: Surveyed payers will accept a price premium for ferric citrate when compared with the estimated price for generic sevelamer carbonate.
Comments from Decision Resources Group Business Insights Analyst Jihan Khan, Ph.D.:
- "Given the available agents to treat renal anemia are similar and limited in number, it is not surprising that the possible launch of HIF-PHi will increase the competition for patient share in renal anemia as they would provide nephrologists with an additional option with a unique mechanism of action and offer a new mode of delivery for the treatment of renal anemia."
Comments from Decision Resources Group Business Insights Director Rob Dubman:
- "In recent years, the renal anemia market has encountered and will continue to face uncertainties due to many factors, including the dialysis bundle, ESA safety concerns, and the use of iron to offset ESA use. Physicians may be skeptical of new agents, and finally, in this cost sensitive market, price will be key to a successful launch of any new renal anemia agent."
The recently published report entitled ChartTrends: Renal Anemia CKD-ND (US) 2014 will help manufacturers understand how renal anemia patients are currently treated through a review of 1,000 CKD-ND patient charts including patient characteristics such as Hb levels (at referral to a nephrologist and on a monthly basis over the last year), ESA treatment, and detailed analyses evaluating the profiles of patients considered candidates for HIF-PHi to help define patient types and identify therapy triggers.
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