BURLINGTON, Mass., July 7, 2015 /PRNewswire/ -- Decision Resources Group finds that there are similarities and differences in dialysis patient management in the U.S. versus the EU5. In 2015, based on information submitted by U.S. and EU5 nephrologists from approximately 1,870 dialysis patient charts combined, ESAs and phosphate binders are the most commonly used renal medications in dialysis patients; however, the use of IV iron differs considerably between the two regions.
Other key findings from the ChartTrends reports entitled Nephrology in Dialysis (US) 2015 and Nephrology in Dialysis (EU5) 2015:
- Hemoglobin at ESA Initiation: In the U.S. and the EU5, physicians report a higher mean hemoglobin at ESA initiation versus the audited patient charts. However, the audited hemoglobin at ESA initiation is lower in the U.S. compared with the EU5. These reports also cover phosphorus at phosphate binder initiation, hemoglobin, ferritin and transferrin saturation (TSAT) at IV iron initiation, parathyroid hormone (PTH) at Amgen's Sensipar/Mimpara initiation, as well as other laboratory parameters at treatment initiation.
- IV Iron Discontinuation Rates: Chart audits indicate that a low percentage of dialysis patients were discontinued from IV iron; the more common reasons for discontinuation include completion of repletion course and ferritin/TSAT level. In addition, higher rates of IV iron discontinuation exist in the U.S. than in the EU5. This may be one of many reasons for higher rates of oral iron use in the U.S. These reports also cover ESAs, phosphate binders, nutritional Vitamin D, active Vitamin D and Amgen's Sensipar/Mimpara discontinuation rates as well.
- Dialysis Patient Characteristics: The percentage of dialysis patients that have had a blood transfusion in the past year is one characteristic in particular where there were large differences between the U.S. and the EU5. Several questions related to patient demographics are included such as age, gender, location of their dialysis, hospitalization rates, reason for recent hospital admission, co-morbidities, primary cause of renal disease, hemoglobin level at time of blood transfusion, calcification, monthly laboratory parameters for hemoglobin, TSAT, ferritin, phosphorous, calcium, PTH, and potassium among other characteristics. These demographics allow manufactures to see differences between treated and non-treated patients.
- Potential Use of Emerging Therapies: Physicians reviewed product profiles of various emerging therapies and were asked whether a particular patient would be started on this therapy now (assuming regulatory approval). This methodology allows manufactures to see a potential percentage for use and patient profiles that includes critical information such as relevant laboratory values for treatment initiation.
Comments from Decision Resources Group Director Rob Dubman:
- "This is now the fourth U.S. ChartTrends report focused on dialysis patient management since the implementation of dialysis bundle, which we believe led to additional scrutiny and awareness of the total costs of treatment. In 2015, in the U.S., there has been a stabilization of the historical decline in the use of ESAs as well as lower mean hemoglobin levels at most recent measure. However, the increase in blood transfusion rates is a concerning phenomenon."
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SOURCE Decision Resources Group