If a dialysis center goes to use Omontys which is a monthly dose then they will create 10-13 times higher patient inflow as compared to the center using EPO. That means the theory about 2/3 market capture by EPO due to Davita and Fresenius is just not true. We will see the patient shift toward the centers using OMONTYS due to ease and they have to go only once in month as compared to 10-13 times in a month. Why this is not encountered in the calculation.
It means that OMONTYS can increase the number of patient by 10-13 times. Will it be possible that patients going to EPO clinics will move away from them and clinics suing EPO can easily accept them due to higher patient throughput.
I believe OMONTYS will get more than 1/3 market share as predicted by analyst. I understand the Davita and other company has contract with Amgen but patients have no contracts with dialysis company.
In my opinion, OOMONTYS has greater than 70 % coverage because patients are going to move away from Davita and other EPO user clinics. Even 33% centers using OMONTYS can treat all the dialysis patients in this country.Only factor is the location. If they are in close vicinity of these EPO centers then EPO is gone out of the market completely. No matter if there is a contract or not.
You raise a good point .
My wife said that they ( the hospital ) gets paid to keep hgb within range --thats what they need Omonty to do .
If you can find any data on that please share --maybe as a topic so the info doesnt get lost in a thread.
"monty has to work well at keeping hgb within target range" Could this have been part of the ph3 trials to keep it within the range? are there any other alternatives or liniency (of it not being within specs?)
Hi I'm the wife of akanz2. Our clinic is output but hospital based,so we are under slightly different license than free standing units.as such we cannot have dialysis technicians handle or draw or dispense meds. We have no other patient care staff beyond nurse and techs, and techs all have to be certified.
We see 52 pts per day,4 shifts 13 pts each shift. We made switch from epo to aranesp.
Aranesp was touted as better than epo, supposed to be once month dose and save money and nurse time etc .But never panned out clinically - has
been at best 2x month dose,but more commonly 1x week.
We actually used more Aranesp, so didn't save money. Now we use it as well as epogen.,some pts respond better to epogen-anemia is better
Significant subset of pts are over hgb target on lowest dose of
Aranesp . They do much better on epo which can be more tightly adjusted at
lower doses and this need for titration could be issue for new drug.
Omonty has to work well at keeping hgb within target range . Something that could be difficult to do if only administered once a month.
As regards EPO .. Allow a minimum of 5 minutes per patient per dose plus record keeping . We see over 50 patients a day ? About 1/3rd of those on EPO .... They get EPO one to three times a week so I,ll let you do the math Bottom line
If Omonty keeps hgb within target range , it will be a significant savings in labor time .
Well congratulations . I think you have finally persuaded my wife ..a physicians assistant in dialysis , to comment on this board ...hopefully I can get her to do it tomorrow.
Something you said about dialysis nurses having nothing to do ...started steam coming out her ears.....hopefully more tomorrow
It is like filling out a weekly activity report in salesforce on a daily bases. You hate doing itand it takes valuable time away from you but it has to be done. In regards to Hospital administration i just saw a report on cnn about nurses being extremely under worked at dialysis clinics nationwide. The report clames, nurses blame EPO for this as less work is needed and often,they have to create extra work to justify their positions at the clinics. These positions are paid for paid by the goverment, so they are concerned. According to the lates report, however, affymax's omontys will create the work needed to justify clinic's existance by requiring 13x more papaer work so in
essense this will provide the necessary monetary backing from our goverment.
How is this for BS? Not as good as montismuso but getting there. Just need more practice! Strong buy EPO, affymax is great, and regards to the buyout; no.
she is right... HOWEVER, clinics have more than 1 nurse on staff, in addition, nurses aids and other "secondary" patient care employees can also prep Epo and draw blood etc...
Thus, it is not ONLY your wife who is prepping all 20 patients Epo injections simeoltaneously, rather, nurses can delegate their workload to aids and other qualified employees on hand. So the workload isnt as daunting and gets done quicker. It may take 5 mins for 1 inj however, with multiple helpers on hand she can get this done a bit quicker than 100mins.
My wife just got home from her shift at the dialysis unit she works in.
When I asked her about the 5 minutes to draw and administer EPO -- her response was " maybe in a perfect set up "
She explained as follows --- she has on average 20 patients a shift.
She can NOT pre draw the EPO in advance for all 20 .
Each patient's EPO has to be drawn at the time it is administered -and often modified before administering -- then followed by record keeping
So -please chk my calculations
Take the 20 patients on Monday -- these get EPO 3 times in the week ( I,m excluding the Tuesday /Thursday patients for now.
Anyway -the 20 patients she starts with on Monday the 1st for example -- she will administer EPO 60 times that week ( 3 times a week per patient )--240 times that month ---to those 20 patients
An a best case scenario of 5 minutes a patient you are looking at 20 hrs of work
A worst case scenario -- drawing the EPO one patient at a time , modifying dosage , record keeping --10 minutes a patient = 40 hrs of work per month on 20 patients
With Omonty --once a month
20 patients , best case scenario at 5 minutes each= 100 minutes = 1 hr and 40 minutes
20 patients -worst case scenario - 10 minutes each =200 minutes per month = 3 hr 20 and minutes PER MONTH
EPO for 20 patients takes 20 to 40 hrs per month
Omonty for 20 patients takes 1hr and 40 minutes to 3 hr and 20 minutes per month
You are saving anywhere from at least 18 hrs to 36 hrs per month in labor time PER 20 PATIENTS
So if you feel up to it , try calculating that out for the total population on dialysis taking EPO 3 times a week ---- FOR A YEAR
That why Hospital administrators are interested .
Everything your mother said about staff levels cut to bare minimum etc ..absolutely correct