Uniquely Velphoro: Flexible administration options add to patient convenience and control1

Easy to break or crush, easy to chew, easy starting dose

Dr Coyne discusses the value of low pill burden and flexible administration in helping patients remain on treatment (1:15 minutes).

Flexible administration with Velphoro: Daniel Coyne, MD*

  • Patients can choose the way they take Velphoro: break, crush, or chew1
  • Taken just before, during, or just after a meal or snack1
  • Can be taken without water, for all-day convenience1

Uniquely Velphoro: Data show giving patients choices improved acceptance†3


When given a choice to chew Velphoro or break and swallow†3:



8 out of 10

 patients accepted Velphoro


of patients chose
to break and swallow

Velphoro dosing is simple for patients, easy for healthcare providers1


starting dose

1 tablet per meal
3 tablets per day1

Titrate by 1 tablet per day,

as required 

Increase by 1 tablet per day
(not per meal) 
until serum phosphorus 
levels are under control, 
as often as weekly1


phosphorus control

Most patients required
3-4 tablets per day,
HALF the pills
vs some other binders1,4


High adherence demonstrated in clinical and real-world settings4,5



Adherence in the largest registrational phosphate binder clinical study (N=1,054)‡4


Medication possession ratio (MPR) in a 6-month,

real-world analysis of pharmacy service data (n=30)§5

In the real-world analysis§5:

  • Adherence was measured by the MPR, which was calculated as the number of days for which there was active binder supply5
  • Analysis of MPR in a subset of patients (those not enrolled in the automated refill service) suggests that improvement in MPR may be the result of better adherence to therapy (MPR improvement from 0.68 to 0.80)3

MPR >80% is generally defined as having good medication adherence6

*Presenter is a paid speaker and has been compensated for their time.

Prospective analysis of 105 patients on hemodialysis to assess acceptance and strategies that support compliance in clinical practice. All patients were on a phosphate binder: at baseline, 57 were switched to Velphoro and 48 maintained their baseline treatment. Patients were informed about various modes of administration and were permitted to adapt administration based on preference.3

A 52-week, open-label, active-controlled, phase 3 study evaluated the safety and efficacy of Velphoro in lowering serum phosphorus levels in patients (N=1,054) with chronic kidney disease on hemodialysis or peritoneal dialysis. In the titration phase (first 24 weeks), patients were randomized to receive either Velphoro or sevelamer carbonate to establish the noninferiority of Velphoro to sevelamer carbonate in lowering serum phosphorus at 12 weeks (secondary endpoint). The following withdrawal phase (weeks 24 to 27, n=93) established the superiority of Velphoro with an effective maintenance dose over a placebo-like low dose (primary endpoint). During a final long-term maintenance phase (weeks 28 to 52, n=658), patients continued phosphate binder treatment according to their original randomization for the assessment of long-term efficacy, safety, and tolerability.1

§A retrospective analysis of deidentified pharmacy data from adult hemodialysis patients (n=490) who were enrolled with the DaVita pharmacy service for at least 6 months. Subjects were patients who converted to Velphoro monotherapy from another phosphate binder during routine care between April 2014 and September 2016. The decision to switch phosphate binders (PBs) was made on a clinical basis and the reasons underlying this change were not available. Primary outcomes were total daily PB pill burden, total PB medication possession ratio, serum phosphorus, and percentage of patients with serum phosphorus ≤5.5 mg/dL.5

References: 1. Velphoro® [package insert]. Waltham, MA: Fresenius Medical Care North America: 2020. 2. Lanz M, Baldischweiler J, Kriwet B, Schill J, Stafford J, Imanidis G. Chewability testing in the development of a chewable tablet for hyperphosphatemia. Drug Dev Ind Pharm. 2014;40(12):1623-1631. 3. Arenas Jiménez MD, Navarro González JF. How to improve adherence the captors of phosphorus on hemodialysis: experience in real life with sucroferric oxyhydroxide. Nefrologia (Engl Ed). 2020;40(6):640-646. 4. Floege J, Covic AC, Ketteler M, et al; on behalf of the Sucroferric Oxyhydroxide Study Group. Long-term effects of the iron-based phosphate binder, sucroferric oxyhydroxide, in dialysis patients. Nephrol Dial Transplant. 2015;30(6):1037-1046. 5. Gray K, Ficociello LH, Hunt AE, Mullon C, Brunelli SM. Phosphate binder pill burden, adherence, and serum phosphorus control among hemodialysis patients converting to sucroferric oxyhydroxide. Int J Nephrol Renovasc Dis. 2019;12:1-8. 6. Anghel LA, Farcas AM, Oprean RN. An overview of the common methods used to measure treatment adherence. Med Pharm Rep. 2019;92(2):117-122.