Hyperkalemia describes abnormally elevated levels of serum potassium, a complication that occurs frequently among patients with renal insufficiency and/or heart failure. High serum potassium levels can have serious cardiac and neurological consequences, including death. Across the G7 pharmaceutical markets (United States, France, Germany, Italy, Spain, the United Kingdom, and Japan), advances in medical technology and aging populations are likely to contribute to increased prevalence of heart failure and chronic kidney disease and consequently a larger pool of patients at risk for hyperkalemia.

Acute hyperkalemia is a medical emergency typically requiring immediate intervention. However, chronic hyperkalemia, defined as serum potassium > 5.0 mEq, requires ongoing monitoring and treatment, typically with potassium-sparing diets, adjustment of potassium-loading medications (e.g., renin-angiotensin-aldosterone system [RAAS] inhibitors), and treatment with potassium binders (e.g., Kayexalate). Interviewed physicians lament the need for efficacious therapies for key subpopulations, such as dialysis patients, and treatments that work alongside RAAS inhibitors. Inhibition of the RAAS is a key strategy in treating hypertension, cardiovascular, and renal diseases. However, RAAS inhibitors are known to increase the risk of hyperkalemia.

Novel potassium binders, such as Vifor FMC Renal Pharma’s Veltassa and AstraZeneca’s Lokelma, have demonstrated long-term efficacy and safety in controlling serum potassium in patients with a history of hyperkalemia and we expect these agents to drive significant sales within the chronic hyperkalemia market.

At DRG, we forecast the G7 hyperkalemia market to expand to more than $2 billion by 2024, driven by the new potassium binders Veltassa and Lokelma, better medical education regarding the prevention of hyperkalemia, and rising prevalence of diabetes and diabetic kidney disease and an aging population.


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