Because of the lack of disease-modifying agents for CKD, treatment is aimed at minimizing the symptoms and complications arising from progressively diminished kidney function and treating the cause of impaired kidney function. This content specifically explores therapies that aim to halt the progressive decline in kidney function and lower the risk of adverse outcomes such as ESRD, cardiovascular, or renal death. A growing body of evidence shows that SGLT-2 inhibitors benefit CKD patients. This report examines the performance of key SGLT-2 inhibitor brands and remaining unmet need in a difficult-to-treat and highly prevalent disease.

QUESTIONS ANSWERED

  • How do nephrologists rate SGLT-2 inhibitors, diuretics, and RAAS inhibitors on selected renal endpoints?
  • Which attribute has the greatest unmet need: preservation of eGFR or reduction in the risk of progression to ESRD?
  • How do drug attributes such as risk of MACE and drug price influence prescribing preference?
  • Do U.S. and European nephrologists have different perceptions of unmet need in the treatment of CKD?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European nephrologists for a hypothetical new CKD drug?

PRODUCT DESCRIPTION

Provides quantitative insight into U.S. and European physician perceptions of key treatment drivers and goals and the current level of unmet need for a specific disease. Commercial opportunities are analyzed, and the extent to which emerging therapies may capitalize on these opportunities is evaluated.

Markets covered: United States, United Kingdom, France, Germany

Primary research: Survey of 61 U.S. and 30 European nephrologists fielded in March 2021

Key companies: AstraZeneca, Johnson and Johnson, Eli Lilly

Key drugs: Invokana, Jardiance, Farxiga

Table of contents

  • Chronic Kidney Disease - Unmet Need - Chronic Kidney Disease | Unmet Need | US/EU
    • Executive Summary
      • Unmet Need - Chronic Kidney Disease- Executive Summary - June 2021
    • Introduction
      • Overview
      • Methodology
      • Rationale for Treatment Drivers and Goals Selection
        • Rationale for Drug Selection
          • Products for Chronic Kidney Disease and Rationale for Drug Selection
      • Treatment Drivers and Goals
        • Key Findings: Attribute Importance
        • Relative Importance of Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Surveyed Nephrologists' Prescribing Decisions in Chronic Kidney Disease
        • Importance of Efficacy Attributes to Prescribing Decisions in Chronic Kidney Disease: United States
        • Importance of Efficacy Attributes to Prescribing Decisions in Chronic Kidney Disease: Europe
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Chronic Kidney Disease: United States
        • Importance of Safety and Tolerability Attributes to Prescribing Decisions in Chronic Kidney Disease: Europe
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in Chronic Kidney Disease: United States
        • Importance of Convenience of Administration Attributes to Prescribing Decisions in Chronic Kidney Disease: Europe
        • Key Findings: Stated vs. Derived Importance
        • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Chronic Kidney Disease: United States
        • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in Chronic Kidney Disease: Europe
      • Product Performance Against Treatment Drivers and Goals
        • Key Findings
        • Overall Performance of Key Therapies for Chronic Kidney Disease: United States
        • Overall Performance of Key Therapies for Chronic Kidney Disease: Europe
        • Mean Overall Performance of Key Therapies for Chronic Kidney Disease: United States and Europe
        • Relative Performance of Key Therapies for Chronic Kidney Disease Across Select Efficacy Attributes: United States
        • Relative Performance of Key Therapies for Chronic Kidney Disease Across Select Efficacy Attributes: Europe
        • Relative Performance of Key Therapies for Chronic Kidney Disease Across Select Safety and Tolerability Attributes: United States
        • Relative Performance of Key Therapies for Chronic Kidney Disease Across Select Safety and Tolerability Attributes: Europe
        • Relative Performance of Key Therapies for Chronic Kidney Disease Across Select Convenience of Administration Attributes: United States
        • Relative Performance of Key Therapies for Chronic Kidney Disease Across Select Convenience of Administration Attributes: Europe
      • Assessment of Unmet Need
        • Key Findings: Unmet Need in Chronic Kidney Disease
        • Surveyed Nephrologists’ Satisfaction with the Performance of Key Therapies for Chronic Kidney Disease on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
        • Surveyed Nephrologists’ Satisfaction with the Performance of Key Therapies for Chronic Kidney Disease on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
        • Surveyed Nephrologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Chronic Kidney Disease: United States
        • Surveyed Nephrologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in Chronic Kidney Disease: Europe
        • Surveyed Nephrologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Chronic Kidney Disease: United States
        • Surveyed Nephrologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in Chronic Kidney Disease: Europe
        • Surveyed Nephrologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Chronic Kidney Disease: United States
        • Surveyed Nephrologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in Chronic Kidney Disease: Europe
        • Key Findings: Unmet Need in Chronic Kidney Disease and Related Indications
        • Surveyed Nephrologists' Ascribed Level of Unmet Need in Chronic Kidney Disease and Related Indications: United States
        • Surveyed Nephrologists' Ascribed Level of Unmet Need in Chronic Kidney Disease and Related Indications: Europe
      • Opportunity Analysis
        • Areas of Opportunity in the Chronic Kidney Disease Market and Emerging Therapy Insights
          • Opportunity: A Novel Agent That Significantly Prevents Disease Progression to ESRD
          • Opportunity: A Novel Agent That Offers Improvement in eGFR
          • Opportunity: A Novel Agent That Improves Cardiovascular Outcomes
      • Target Product Profiles
        • Assessing Drug Development Opportunities
        • Target Product Profile Methodology
          • Attributes and Attribute Levels
        • Attribute Importance and Part-Worth Utilities
          • Chronic Kidney Disease Target Product Profile: Attribute Importance
          • Preservation of eGFR Compared With Placebo
          • Reduction in Urine ACR
          • Reduction in CV Deaths
          • Reduction in Hospitalization due to Heart Failure
          • Reduction in Risk of Progression to ESRD
          • Reduction in Risk of MACE
          • Price per Treated Day
        • Conjoint Analysis-Based Simulation of a Market Scenario
          • Chronic Kidney Disease Market Simulation: Share of Preference of Target Product Profiles Included in the Market Scenario
          • Chronic Kidney Disease Market Simulation: Likelihood to Prescribe Target Product Profiles Included in the Market Scenario
          • Chronic Kidney Disease Market Simulation: Target Product Profiles Included in the Market Scenario
      • Appendix
        • Key Abbreviations
        • Bibliography

    Author(s): Dwaipayan Chatterjee, M.Pharm.

    Dwaipayan Chatterjee, M.Pharm., is an analyst on the Cardiovascular, Metabolic, Renal, and Hematologic (CMRH) Disorders team at Clarivate. He has authored reports focusing on metabolic and cardiovascular indications. Previously, he was an equity analyst for the U.S. healthcare sector with Market Realist, where he worked on competitive intelligence and analysis of financial data. He was also a market research analyst for Mordor Intelligence, where he gained experience in market sizing, forecasting, and analyzing market dynamics. He holds a master’s degree with a specialization in pharmaceutical chemistry from the Birla Institute of Technology & Science in Pilani, India.