Spherix Global Insights

August 10, 2022

Primary Care Providers Report a High Unmet Need for New Therapeutic Treatment Options for Chronic Kidney Disease, Despite Earlier Intervention and Referrals to Nephrologists, Spherix Reports

Spherix’s third bi-annual audit analyzed the charts of 1,002 CKD non-dialysis patients with moderate to severe kidney disease treated by primary care physicians

EXTON, Pa., July 9, 2021 /PRNewswire./ – Approximately 37 million Americans have chronic kidney disease (CKD)—that is one out of every seven U.S. adults.1 Many of these patients are being managed by primary care physicians (PCPs) but are unaware of their kidney disease. In fact, just 10% of people with chronic kidney disease are aware of their condition.2 As such, referrals to nephrologists often vary and are inconsistent across providers.

To better understand how PCPs are managing CKD patients, Spherix Global Insights collaborated with 228 PCPs to perform a retrospective chart audit of 1,002 patients. The study found that PCPs are often taking the initial critical steps in disease identification and treatment initiation. While most PCPs recognize the benefits of referring these patients to nephrology care early in their disease progression, a minority are substantially more delayed in their referrals. This is important, as participating PCPs report their own comfort managing CKD patients wanes drastically as their disease advances.

Although PCPs reflect favorably on the quality of co-management between themselves and nephrologists, more than one-half of audited CKD non-dialysis patients (Stages 3 through 5) have not yet been referred to a nephrologist. Referrals are often hindered because the PCP feels they are effectively managing the patient on their own, the patient’s CKD is not progressing rapidly, or they perceive their labs as not warranting a referral. Wait times to see a nephrologist also impact referrals and overall patient care; a Spherix audit conducted in 2018 provided that just over one-quarter of PCPs considered the time to see a nephrologist “long,” and that percentage has grown to nearly one-third in 2022.

When it comes to treatment, PCPs rank CKD within the top three disease areas that have a “high” unmet need for new therapeutic treatment options. Recent regulatory decisions by the FDA have hampered innovation in the renal field, including the rejection of potential blockbuster therapies such as the hypoxia-inducible factor prolyl hydroxylase inhibitors (HIF-PHi), namely roxadustat (FibroGen/AstraZeneca) and vadadustat (Akebia) for the treatment of anemia, and Ardelyx’s tenapanor for hyperphosphatemia.

However, the approval of other therapies proven to slow the progression of renal decline, such as AstraZeneca’s SGLT2 inhibitor, Farxiga and Bayer’s nonsteroidal mineralocorticoid receptor antagonist (MRA), Kerendia, has encouraged more proactive treatment of CKD and its associated comorbidities. Both PCPs and nephrologists are beginning to show a shift in their approach to early care of CKD patients.

In line with Spherix’s nephrology audit, PCP use and initiation of SGLT2 inhibitors in CKD non-dialysis patients is increasing. The approval of Farxiga over a year ago to treat both DKD and non-diabetic CKD patients has bolstered its share to account for one-in-four SGLT2 inhibitor prescriptions. However, Eli Lilly/Boehringer Ingelheim’s Jardiance represents more than one-half of SGLT2 inhibitor prescriptions despite not yet having the indication for CKD care. Notably, while the majority of patients prescribed an SGLT2 inhibitor have diabetes, nearly one-quarter have CKD without diabetes, pointing to earlier intervention and preemptive treatment decisions among PCPs.

As the prevalence of CKD continues to increase in the US and novel therapies emerge, most PCPs report that they do seek information about CKD – often sourcing content from online resources and nephrology colleagues. There is strong opportunity for biopharmaceutical companies with renal products to provide the necessary education and materials to encourage earlier and more proactive care and referrals for CKD patients to optimize their treatment.

About RealWorld Dynamix™
RealWorld Dynamix™ is an independent, data-driven service unveiling real patient management patterns through rigorous analysis of large-scale patient chart audits. Insights reveal the “why” behind treatment decisions, include year over year trending to quantify key aspects of market evolution, and integrate specialists’ attitudinal & demographic data to highlight differences between stated and actual treatment patterns.

About Spherix Global Insights
Spherix Global Insights is a hyper-focused market intelligence firm that leverages our own independent data and expertise to provide strategic guidance, so biopharma stakeholders make decisions with confidence. We specialize in select immunology, nephrology, and neurology markets.

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