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CVS Faces Challenges, Opportunities in Home Dialysis Market

By John Commins  
   April 11, 2018

The retail pharmacy giant has the potential to be a game-changer in the highly concentrated, $34 billion kidney dialysis industry, using its ubiquitous retail presence to push consumers into home dialysis.

CVS Health's announcement that it will enter the kidney home dialysis market presents the company with as many challenges as opportunities, says industry analyst Jack Curran.

"The dialysis market right now is very concentrated," says Curran, a senior analyst with IBISWorld.

"If any company is going to be able to move into this industry and succeed it is going to have to be a large company with a lot of resources, like CVS," he said. "Right now, with their very heavy M&A activity, in trying to grow their healthcare offerings, CVS is probably going to be very well positioned to succeed."

The biggest challenge for CVS in the kidney dialysis market is its lack in-center dialysis. Fresenius Medical Care and DaVita control about 95% of the in-center market, and Curran estimates that 8% or less of all dialyses occur in the home.

Nearly 700,000 people have end-stage renal disease, and nearly 500,000 of these patients are on active dialysis and more than 120,000 new ESRD cases are diagnosed each year.

Medicare spends nearly $34 billion each year on dialysis patient care.

Bruce Culleton, MD, CMO at CVS Specialty, says the high costs of dialysis are not reflected in the outcomes, noting that mortality rates for Medicare patients treated with in-center hemodialysis are up to 10 times higher than among the general Medicare population.

"While in-center dialysis clinics are currently the most common choice for hemodialysis treatment, published clinical research has shown improved cardiac health, metabolic control, and survival for patients who are treated with longer, more frequent dialysis treatments. This treatment paradigm is best delivered in the convenience of a patient's home," Culleton said.

John Commins is a senior editor at HealthLeaders.

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