This third-time report focuses on the management of diabetic nephropathy (DN) in the United States. The U.S. market for DN drugs is poised to expand owing to the growing size of the DN patient population and the upcoming potential launches of novel therapies, such as AbbVie’s atrasentan and NephroGenex’s pyridoxamin dihydrochloride (Pyridorin). This report provides insight into practice patterns, attitudes, and perceptions as well as current and projected use of various products used to treat DN. It also evaluates perceived aided familiarity, interest, and percentage of patients who are likely candidates by chronic kidney disease (CKD) stage for six product profiles of agents in clinical development.

Questions Answered in This Report:

  • Understand the DN patient population being treated by nephrologists, endocrinologists, and PCPs and uncover recent changes in treatment. How many patients with DN are physicians treating, and how does this number compare with the total number of patients in their practice? Do they treat more new or existing patients, and how does this differ by physician specialty? How many DN patients have microalbuminuria versus macroalbuminuria and what is the severity of their CKD? How quickly do DN patients progress from diagnosis to complications, and what risk factors influence progression? What are considered the gold-standard tests for diagnosing DN?

  • Understand how nephrologists, endocrinologists, and PCPs diagnose, refer, and treat patients with DN and how therapy decisions differ based on disease presentation and specialty of the treating physician. Angiotensin-converting enzyme inhibitors (ACEIs) and lipid-lowering agents are commonly used by nephrologists, endocrinologists, and PCPs for patients with DN. How does preference differ for these medications by physician specialty? What is the patient share for insulin and noninsulin diabetic medications among DN patients? Which attributes are most important when choosing an agent for DN, and how does this vary by physician specialty? What are the referral patterns by physician specialty, and in what stage of CKD are patients referred from a PCP to a nephrologist?

  • Understand physicians’ level of satisfaction with current DN treatments, perceived need for new treatments, and awareness of and expectations for potential new products in development for DN. What is the level of familiarity and interest in products in development for DN, including Janssen’s Invokana, AbbVie’s atrasentan, NephroGenex’s Pyridorin, Bayer’s finerenone, ChemoCentryx’s CCX-140, and Noxxon’s ematicap? What percentage of patients, by stage, are likely candidates for six profiled DN products in development? What trial end points are most important for agents in development, and which mechanisms of action hold the most promise for the treatment of DN?


Markets covered: United States.

Primary research: This report is based on a survey of 157 respondents: 51 nephrologists, 50 endocrinologists, and 56 PCPs.

Screening criteria: Physicians were required to be in practice for at least 2 and no more than 30 years and devote more than 75% of their professional time to patient care as opposed to nonclinical activities such as research or teaching. In addition, respondents were required have at least 50 DN patients under their personal care, and they could not practice in Vermont.

Survey fielding dates: The physician surveys were conducted from August 19-26, 2015. Surveys were completed over the Internet. Applicable prior wave trending is provided from 2012 and 2015.

Report: PowerPoint format with 122 pages of content.

Author(s): Rob Dubman, M.B.A.

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