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RealWorld Dynamix: Dialysis US

The management of renal anemia in dialysis patients as well as in those with later stage chronic kidney disease is becoming increasingly complex. In the dialysis setting, clinical management is further complicated by a reimbursement model that treats commonly used therapies like erythropoiesis stimulating agents (ESAs) and iron therapies as cost centers. Novel products in development such as the oral HIF-Ph inhibitors offer a new mechanism approach and may change the treatment paradigm in both the dialysis and CKD-ND settings. In early 2018, Amgen will roll out the first IV calcimimetic, Parsabiv, which will largely compete with its own Sensipar.

This annual report series focuses on how actual treatment patterns are shifting in the dialysis setting. Detailed information on clinical and non-clinical demographics along with treating physician attitudes reveals opportunities for brands to better penetrate the dialysis setting.

RealWorld Dynamix™: Dialysis is based on a deep, robust patient chart analysis of +/- 1,000 dialysis patients. Each nephrologist (+/-200) completes an in-depth medical history of the most recent 3-7 patients who met the study inclusion criteria. An excellent augmentation to claims data, this study also captures the clinician’s perspective on the why behind treatment decisions. In addition to patient demographics and treatment history, clinical assessments, diagnostic tests and laboratory values are included to provide insight into the real world treatment patterns in dialysis.

This is the second wave of the annual report.

Learn more about RealWorld Dynamix™ reports here.

  • What are the treatment patterns in renal anemia, hyperphosphatemia, SHPT, and hyperkalemia in the dialysis setting and do these changes vary by chains (i.e. DaVita, FMC)? By dialysis modality?
  • How frequently are the doses of renal medications adjusted and for what reason?
  • What percent of the treated and non-treated population (for ESAs, IV Iron, Active Vitamin D, Sensipar and Phosphate Binders) are within the target ranges for biochemical parameters? Among the non-treated patients in each group what percent were previously discontinued?
  • How do nephrologists rate their patients on adherence levels to dialysis treatments, oral medications and phosphate binders? How do the patient profiles and treatment approaches differ based on these ratings?
  • What percent of the dialysis patients were followed by the same nephrologists in pre-dialysis? For patients referred with no dialysis care, what percent are referred by the hospital/ER? What percent are treated with renal medications in pre-dialysis and how likely are patients to stay on the same brand when transitioning from CKD to dialysis?
  • How do certain co-morbid conditions such as Type 2 diabetes, influence the treatment patterns? How do the profiles of patients on HD differ from those on PD? What are the differences between transplant candidates and those not deemed candidates?
  • What patient types are the newer phosphate binders, Velphoro and Auryxia, being used in?
AbbVie, generics (Zemplar), Amgen (Aranesp, Epogen, Parsabiv, Sensipar), Keryx (Auryxia), FMC, generics (Venofer), Roche/FMC (Mircera), Rockwell Medical (Triferic), Sanofi, generics (Ferrlecit, Hectorol, Renvela), Shire (Fosrenol), Relypsa (Veltassa), Vifor/FMC (Velphoro), calcitriol, calcium acetate, calcium carbonate, sodium polystyrene sulfonate/em>

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