Question · Q4 2025
Nabil Nassar inquired about the trending of second and third Vafseo refill rates, comments on anemia manager education, and how the AKB-9090 asset is mechanistically differentiated from prior HIFs.
Answer
Chief Commercial Officer Nicholas Grund reported that first refill adherence improved from 75% historically to 91% in Q4 2025 for a small subset, and 87% in January for a larger observed dosing group. He noted significant continuation of adherence through the second prescription, with a 2-4% monthly discontinuation rate due to comorbidities. President, CEO, and Director John Butler added that physician belief in Vafseo's clinical benefit helps patients work through transient GI issues. John Butler and Nicholas Grund also discussed expanding the medical affairs group (MSLs) for education and DaVita's centralized anemia management model. Senior Vice President, Chief Research and Development Officer Steven K. Burke explained that AKB-9090 has different pharmacokinetics and a more widespread tissue penetration (lung, kidney) compared to vadadustat's liver preference, making it more suitable for ischemia-reperfusion injury.
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