Market Report Source

Overview

Introduction
Increased 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”

Table of Contents

TABLE OF CONTENTS

CHAPTER 1 EXECUTIVE SUMMARY

Objective of the analysis

Datamonitor insight into the ESRD market

CHAPTER 2 ESRD DEFINITIONS & SCOPE

Strategic scoping and focus

CHAPTER 3 ESRD MARKET ASSESSMENT

ESRD: a clearly defined disease

Treatment of ESRD

Renal replacement therapy (RRT)

Hemodialysis (HD)

Peritoneal dialysis (PD)

Key factors influencing the ESRD market

The increasing prevalence of ESRD

ESRD occurrence is increasing in an aging population

Increasing causal risk factors – diabetes and hypertension

Comparative use of RRT

Increasing costs of treating ESRD

Healthcare payors concerns in reimbursing dialysis treatment

Drug treatment of dialysis patients

Prevention is better than cure

Comorbidities, symptoms and side effects drive drug treatment costs

CHAPTER 4 COMORBIDITIES WITH ESRD

Introduction

Hypertension

Congestive heart failure

Hypertension-related drug usage in ESRD comorbidities

ACE inhibitors and ARBS are used to treat hypertension

Calcium channel blockers

Diuretics

Dyslipidemia

Drugs for dyslipidemia (lipid-lowering drugs)

Coronary artery disease (linked to dyslipidemia)

Statins

Fibrates

Niacin (nicotinic acid, vitamin B3)

Ion-exchange resins/bile-acid sequestrants

Cholesterol uptake inhibitors

Sevelamer

Diabetes

Myocardial damage

Respiratory diseases (e.g. COPD)

CHAPTER 5 DRUGS TREATING ESRD SYMPTOMS

Introduction

The ESRD anemia market

An overview of anemia

The role of erythropoietin in ESRD-induced anemia

Importance of managing serum levels of iron prior to EPO treatment

Patient treatment patterns

The erythropoietin market

Epogen/Procrit (epoietin alpha)

Aranesp (darbepoietin alpha)

NeoRecormon (epoietin beta)

CERA

Dynepo (epoietin delta)

Epomax (epoietin omega)

Competitive environment in the EPO market

Patent expiries and new entrants

Future dynamics in the ESRD erythropoietin market

The intravenous (IV) iron market

INFeD (iron dextran)

Ferrlecit (iron gluconate)

Venofer (iron sucrose)

Competitive environment in the IV iron market

Patent expiries and new entrants

Opportunities in the IV iron market

The ESRD secondary hyperparathyroidism market

An overview of secondary hyperparathyroidism

ESRD’s impact

Vitamin D and the secondary hyperparathyroidism market

Patient treatment patterns

Competitive environment in the vitamin D market

Patent expiries and new entrants

Future dynamics in the ESRD vitamin D market

Hyperphosphatemia in ESRD patients

Patient treatment patterns

Competition in the ESRD phosphate binder market

Patent expiries

Future dynamics in the phosphate binders market

APPENDIX A

Usual doses of antihypertensive medication

APPENDIX B

Bibliography

Report methodology

About Datamonitor

About Datamonitor Healthcare

About the Cardiovascular Disease analysis team

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