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Commercial Perspectives: Drug Treatment in End-Stage Renal Disease - The Price of FailurePublished by: Datamonitor Published: Jan. 18, 2006 - 118 Pages Table of ContentsTABLE OF CONTENTS CHAPTER 1 EXECUTIVE SUMMARY 3 Objective of the analysis 3 Datamonitor insight into the ESRD market 3 CHAPTER 2 ESRD DEFINITIONS & SCOPE 9 Strategic scoping and focus 11 CHAPTER 3 ESRD MARKET ASSESSMENT 12 ESRD: a clearly defined disease 12 Treatment of ESRD 13 Renal replacement therapy (RRT) 15 Hemodialysis (HD) 15 Peritoneal dialysis (PD) 15 Key factors influencing the ESRD market 16 The increasing prevalence of ESRD 17 ESRD occurrence is increasing in an aging population 17 Increasing causal risk factors - diabetes and hypertension 18 Comparative use of RRT 20 Increasing costs of treating ESRD 21 Healthcare payors concerns in reimbursing dialysis treatment 22 Drug treatment of dialysis patients 23 Prevention is better than cure 24 Comorbidities, symptoms and side effects drive drug treatment costs 25 CHAPTER 4 COMORBIDITIES WITH ESRD 26 Introduction 26 Hypertension 26 Congestive heart failure 27 Hypertension-related drug usage in ESRD comorbidities 27 ACE inhibitors and ARBS are used to treat hypertension 27 Calcium channel blockers 41 Diuretics 44 Dyslipidemia 47 Drugs for dyslipidemia (lipid-lowering drugs) 47 Coronary artery disease (linked to dyslipidemia) 47 Statins 48 Fibrates 51 Niacin (nicotinic acid, vitamin B3) 53 Ion-exchange resins/bile-acid sequestrants 54 Cholesterol uptake inhibitors 54 Sevelamer 55 Diabetes 56 Myocardial damage 57 Respiratory diseases (e.g. COPD) 57 CHAPTER 5 DRUGS TREATING ESRD SYMPTOMS 59 Introduction 59 The ESRD anemia market 60 An overview of anemia 60 The role of erythropoietin in ESRD-induced anemia 60 Importance of managing serum levels of iron prior to EPO treatment 61 Patient treatment patterns 61 The erythropoietin market 62 Epogen/Procrit (epoietin alpha) 63 Aranesp (darbepoietin alpha) 63 NeoRecormon (epoietin beta) 64 CERA 64 Dynepo (epoietin delta) 64 Epomax (epoietin omega) 65 Competitive environment in the EPO market 66 Patent expiries and new entrants 70 Future dynamics in the ESRD erythropoietin market 74 The intravenous (IV) iron market 75 INFeD (iron dextran) 75 Ferrlecit (iron gluconate) 76 Venofer (iron sucrose) 77 Competitive environment in the IV iron market 77 Patent expiries and new entrants 83 Opportunities in the IV iron market 84 The ESRD secondary hyperparathyroidism market 84 An overview of secondary hyperparathyroidism 84 ESRD’s impact 85 Vitamin D and the secondary hyperparathyroidism market 86 Patient treatment patterns 86 Competitive environment in the vitamin D market 91 Patent expiries and new entrants 100 Future dynamics in the ESRD vitamin D market 101 Hyperphosphatemia in ESRD patients 101 Patient treatment patterns 103 Competition in the ESRD phosphate binder market 105 Patent expiries 109 Future dynamics in the phosphate binders market 110 APPENDIX A 111 Usual doses of antihypertensive medication 111 APPENDIX B 114 Bibliography 114 Report methodology 116 About Datamonitor 117 About Datamonitor Healthcare 117 About the Cardiovascular Disease analysis team 118 Disclaimer 119 AbstractIntroductionIncreased prevalence of diabetes, obesity, and cardiovascular disease, all causal factors of renal disease, drives growth of the end-stage renal disease (ESRD) sector. On average, an ESRD patient uses >$7,000 of drugs/year, representing a significant opportunity for pharmaceutical companies in treating the symptoms, comorbid conditions and treatment side effects of ESRD. Scope Analysis of the ESRD sector in the US, and in the 5 major European markets Germany, France, UK, Italy and Spain Analysis of issues facing the ESRD market: rising prevalence, treatment costs and greater focus on prevention, and differences in treatment patterns Insight into drugs in the treatment of comorbidities of ESRD including: hypertension, dyslipidemia and diabetes Review of drugs in the treatment of dialysis side effects including: erythropoietins, IV iron, vitamin D and phosphate lowering drugs Highlights The ESRD market is growing at a rate of 6% in the US, 7% in Japan and 4% in Europe. It is a large cost burden on healthcare payors with treatment costs increasing by a CAGR of 5% to over $60,000 per patient per year. Diabetes and hypertension are considered a causal factor in >72% of the cases of ESRD and cardiovascular disease is the cause of death for over 60% of ESRD patients. The ESRD market represents around 1% of the cardiovascular market, but the overall chronic kidney disease (CKD) market is a much larger target population. Costs of drugs directly treating symptoms of ESRD represent over 14% of the treatment costs. Erythropoietin treatment of renal-disease-related anemia represents over 70% of these costs, followed by vitamin D treatment of secondary hyperparathyroidism. Costs are expected to reduce with the introduction of biosimilars or biogenerics in 2007 to 2010. Reasons to Purchase Gain insight into the dynamics and key issues in the ESRD market Understand how to position drugs used to treat the comorbidities of ESRD patients Look at the opportunities in treating dialysis patients Get Full Details About This Report >> |
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