New BioTrends Report Explores the Clinical and Business Aspects of Renal Anemia From the Perspective of Nurses and Administrator

EXTON, Pa., Sept. 28 /PRNewswire/ -- BioTrends Research Group, Inc. recently published its TreatmentTrends®: The Role of Anemia Managers, Practice Managers and Facility Administrators in the Management of Renal Anemia report, based on online survey results from approximately 150 anemia managers and qualitative interviews with over 35 practice managers and facility administrators. These stakeholders are an important part of the renal anemia care team and are responsible for clinical, logistical and financial aspects of anemia management.

In both the dialysis and chronic kidney disease non-dialysis (CKD-ND) settings, holding erythropoiesis stimulating agents (ESAs) at lower hemoglobin levels and lower hemoglobin targets are the most common recent changes reported by anemia managers. The tight hemoglobin target ranges prove to be a challenge for facility administrators who are often responsible for outcomes in their dialysis units. In an effort to ensure patients receive their full ESA dose, some units have adopted new dosing schedule practices for certain patients. In terms of new ESAs in development, a longer acting product (monthly administration) for maintenance dosing is desired for dialysis and CKD-ND patients, although reasons for preference vary by setting.

A majority of nephrology offices stock and administer ESAs to their CKD-ND patients, but in-office administration of IV iron is far less common. Like nephrologists, anemia managers report a market share advantage for Centocor OrthoBiotech's Procrit over Amgen's Aranesp and although satisfaction rates for the two products are similar, Procrit has a perceived advantage related to managed care and Aranesp has perceived advantages on dosing and administration. Overall, practice managers tend to be pleased with the ordering and delivery process for both ESAs and IV iron products that are stocked and administered in nephrology offices. But, stocking procedures tend to be more firmly entrenched for ESAs compared to IV iron, where offices tend to have less experience. Prior authorizations can be a hassle and some practice managers describe differences between the various ESA and IV iron companies' support programs in this area.

Expanded use of IV iron in both the dialysis and CKD-ND settings is likely due to a number of factors including the promotion of AMAG's Feraheme, practice pattern shifts in reaction to Amgen's TREAT study, and the impending dialysis bundle.  In addition to expanded use of IV iron, bundling is expected to lead to a reduction in the use of ESAs through lower hemoglobin targets and lower ESA doses.  

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