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Patients with iron deficiency anemia who can’t tolerate oral iron supplements or who need faster relief of symptoms may receive an intravenous injection of iron, which deposits the mineral directly into the bloodstream.

Injectafer is one of those injections, and studies show that it is associated with a higher risk of severe hypophosphatemia than competitor products.

Yet instead of changing their product labeling and alerting doctors and patients to this risk, the manufacturer is planning even more marketing campaigns promoting the treatment without the proper warnings.

Daiichi Sankyo Cuts Jobs but Puts More Money Behind Injectafer

According to a recent article in Fierce Pharma, Daiichi Sankyo—parent company to Injectafer’s manufacturer, American Regent—is making job cuts to streamline its business, while simultaneously focusing more resources on selling Injectafer.

Since Benicar, one of the company’s top-selling drugs, was approved as a generic, Daiichi Sankyo has reportedly been struggling financially. So they are cutting 280 jobs in the U.S. and making changes here to prepare for their upcoming oncology pipeline.

According to Ken Keller, president of administrative and commercial for Daiichi Sankyo, “Our priorities are to bring spending in line with revenue, shift resources to maximize Injectafer and our abuse-deterrent pain treatments, and prepare for exciting potential new treatments for patients with cancer being developed by our R&D organization.”

The move follows a previous downsizing of about 1,200 U.S. employees and the transfer of R&D and commercial operations to one location in New Jersey. The company also closed an R&D facility in India last year and cut 150 employees in Japan.

Injectafer Making Millions for Daiichi Sankyo

Genetic Engineering & Biotechnology News reported in March 2018 that according to Daiichi Sankyo’s annual report, released last November, the company was committed to accelerating Injectafer’s growth. They also intended to strengthen their position as the leader in the IV iron market with both Injectafer and Venofer, another similar treatment that contains a different form of iron (iron sucrose). Injectafer delivers ferric carboxymaltose (FCM).

In 2015, Injectafer generated $155 million, while in 2016 it generated $221 million. The company’s goal for the 2017 fiscal year, ending on March 31, 2018, was $300 million in revenue.

Injectafer Linked with Severe Hypophosphatemia

While the company focuses on profits, some patients are suffering from severe side effects. Research has shown that Injectafer, more than other forms of injectable iron, can increase the risk of both hypophosphatemia (HPP) and severe hypophosphatemia. These are conditions in which the body becomes low on phosphate—a combination of the mineral phosphorus and oxygen. The deficiency can cause symptoms like muscle weakness, fatigue, tingling and numbness, and confusion.

Severe cases can be life-threatening, and can cause muscle wasting, respiratory failure, seizures, coma, and fatal arrhythmias. In 2016, researchers compared Injectafer’s medicine (FCM) with another iron supplement called iron isomaltoside. They found that the risk of HPP was greater after an injection of FCM, and that only those injected with FCM in the study suffered from severe HPP.

The manufacturers have not changed the product labeling to alert doctors and patients to the increased risk of severe HPP.

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