Cardiologists Continue to Lag Nephrologists When It Comes to the Adoption of Vifor/Relypsa's Veltassa for Hyperkalemia, but Prescribers in Both Specialties Report Mounting Market Access Pressure
EXTON, Pa., Nov. 16, 2017 /PRNewswire/ -- According to survey feedback gathered from US cardiologists (n=101) and nephrologists (n=102), the use of Veltassa (patiromer FOS) continues to expand as the product enjoys a competitor-free environment. However, uptake among nephrologists continues to outpace that of cardiologists even though the number of patients with hyperkalemia is roughly similar between the specialties.
The level of promotion, specifically the interface with sales representatives, appears to be a major factor in the difference. While 80% of the nephrologists have been called on, less than half of the cardiologists have been detailed. Nephrologists report that Vifor/Relypsa is second only to Amgen when it comes to the frequency of company interaction, however only 2% of the surveyed cardiologists report that Vifor/Relypsa is one of companies with which they most frequently interface. Indeed, cardiologists report that in the past six months, they have seen the Eliquis (BMS/Pfizer) representative an average of 10 times compared to just a single call for Veltassa. Promotion and representative contact is critical, demonstrated by the fact that among cardiologists that have been called on, 93% are using Veltassa and among non-users, 79% report that lack of familiarity with Veltassa is a leading barrier.
Two major challenges are at play that may dampen the projected expansion of Veltassa in the near term. First, users from both specialties report increasing payer pressure. Half of the cardiologists and one-third of the nephrologists report that the paperwork and prior authorization process is the most burdensome aspect of the drug. An increasing percent of Veltassa prescriptions are requiring (PA) prior authorizations and physicians report that, of the PAs completed for Veltassa in the past three months, about one quarter are denied. The second challenge is changing the way clinicians think about and treat hyperkalemia. While Veltassa messaging continues to reinforce chronic use of Veltassa, cardiologists report that for all of the outpatients for whom they have prescribed the drug, in only 27% of the cases was the intention as a chronic, on-going medication (vs. 56% for nephrologists).
About half of the respondents agree that there is a high need for another potassium binder to be approved. AstraZeneca/ZS Pharma's Lokelma (ZS-9, zirconium cyclosilicate) is still under FDA review, having received two Complete Response Letters, leaving the ultimate approval as a question mark. Ardelyx is also developing a potassium binder, RDX7675, which entered Phase 3 trials earlier this year with results from the onset of action trial expected by year end. In particular, physicians indicate that new binders with improved formulations, faster onset of action, a more favorable label relative to drug-drug interactions, and better market access would challenge Veltassa. But, until these agents cross the approval finish line, Veltassa is expected to continue to grow.
RealTime Dynamix™: Hyperkalemia Cardiology US and RealTime Dynamix™: Hyperkalemia Nephrology US are independent report series published on a quarterly basis. The series provide a close-quarters analysis of key performance metrics, focusing on brand gains and losses, industry contact rates, familiarity and adoption rates of recently launched products, and awareness of products in development. The next wave of the study will be released in December 2017.
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Spherix Global Insights is an independent market intelligence agency, specializing in renal, autoimmune, neurologic and rare disease markets. Our aim is to apply our commercial experience and unique relationships within core specialty markets to translate data into insight, enabling our clients to make smarter business decisions.
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