Vadadustat Market
The market for Vadadustat was estimated at $276 million in 2025; it is anticipated to increase to $389 million by 2030, with projections indicating growth to around $549 million by 2035.
Report Summary
Market Data
Methodology
Table of Contents
Global Vadadustat Market Outlook
Revenue, 2025
$276M
Forecast, 2035
$548M
CAGR, 2026 - 2035
7.1%
The Vadadustat industry revenue is expected to be around $276.3 million in 2026 and expected to showcase growth with 7.1% CAGR between 2026 and 2035. Building on this outlook, the global Vadadustat market is consolidating its position as a critical component of advanced anemia management, driven by the escalating prevalence of chronic kidney disease, a rising burden of cancer-related anemia, growing emphasis on improving patient quality of life, and strong preference for convenient oral hypoxia-inducible factor prolyl hydroxylase inhibitor therapies over injectable alternatives, ensuring the Vadadustat industry remains highly relevant across both dialysis and non-dialysis patient segments.
Vadadustat, also known as Vafseo, is an orally administered hypoxia-inducible factor prolyl hydroxylase inhibitor designed to stimulate endogenous erythropoiesis, offering a differentiated mechanism of action for CKD anemia treatment and cancer-related anemia treatment, with these two indications together accounting for 100.0% of current application revenues in the Vadadustat industry. The dominance of the 450 mg dosage strength, which generated $142.56 million in sales in 2025, underscores strong physician and payer confidence in this regimen, while recent trends such as broader adoption in earlier-stage chronic kidney disease patients, optimization of dosing strategies, and integration into evidence-based anemia management protocols are reinforcing demand and shaping the future trajectory of the global Vadadustat market.
Market Key Insights
The Vadadustat market is projected to grow from $276.3 million in 2025 to $549 million in 2035. This represents a CAGR of 7.1%, reflecting rising demand across CKD Anemia and Cancer-related Anemia.
This is a highly consolidated market with 2 key players, where Akebia Therapeutics Inc. holds the dominant share.
U.S. and Japan are the top markets within the Vadadustat market and are expected to observe the growth CAGR of 4.6% to 6.8% between 2025 and 2030.
Emerging markets including India, Brazil and South Africa are expected to observe highest growth with CAGR ranging between 8.2% to 9.8%.
End-User Companies within Chronic Kidney Disease are adopting transition like From EPO based Anemia Treatments to HIFPHI Therapies; and this trend is expected to give an additional push of $12 million to Vadadustat industry b/w 2025 and 2030.
The Vadadustat market is set to add $272 million between 2025 and 2035, with manufacturer targeting Cancer-related Anemia Application projected to gain a larger market share.
With
the rising prevalence of anemia, and
Advances in Renal Disease Therapeutics, Vadadustat market to expand 99% between 2025 and 2035.
Opportunities in the Vadadustat
European regulators and payers are also increasingly receptive to oral HIF stabilizers such as Vadadustat to manage renal anemia in both dialysis and non-dialysis chronic kidney disease populations. Aging demographics and high prevalence of CKD drive sustained demand for convenient oral dosing and improved quality of life. Market access strategies emphasizing cardiovascular safety data and real-world effectiveness will be crucial. The 150 mg Vadadustat segment should see notable expansion, rising worldwide from $90.62 million in 2025 to $123.57 million by 2030.
Growth Opportunities in North America and Asia-Pacific
In North America, Vadadustat adoption will be anchored primarily in CKD anemia, where the large chronic kidney disease and dialysis population, combined with pressure to optimize total cost of care, creates a strong clinical and economic rationale for an oral HIF-PH inhibitor. The dominant opportunity is to position Vadadustat as a next-generation CKD anemia treatment for non-dialysis and early-stage CKD patients who are sub-optimally managed or under-treated with ESAs, emphasizing convenience, potential cardiovascular safety advantages, and reduced need for clinic-based injections. Competitive intensity is high, with entrenched ESAs, biosimilars, and other hypoxia-inducible factor stabilizers in the clinical pipeline, so differentiation will depend on real-world evidence, head-to-head outcomes, and payer-facing pharmacoeconomic models. Key regional drivers include a well-established nephrology infrastructure, value-based reimbursement models, and accelerated pathways for innovative renal anemia drugs, making strategic partnerships with integrated health systems, dialysis chains, and pharmacy benefit managers critical for formulary access and rapid uptake. While cancer-related anemia remains a smaller application segment in this region due to safety concerns and restrictive guidelines around erythropoiesis-stimulating therapies, there is a niche opportunity for Vadadustat in oncology-supportive care where oral anemia therapy and reduced transfusion burden can be demonstrated in carefully selected populations.
In Asia-Pacific, Vadadustat’s most influential application will also be CKD anemia, driven by a rapidly expanding chronic kidney disease burden linked to diabetes and hypertension, coupled with under-penetration of conventional ESAs in many markets. The top opportunity is to deploy Vadadustat as an accessible oral anemia therapy that can bridge gaps in care outside major dialysis centers, particularly in countries where hospital-based injectable ESA administration is constrained by infrastructure, distance, or out-of-pocket costs. Competitive dynamics feature a mix of multinational ESA brands, emerging biosimilars, and local manufacturers exploring HIF-PH inhibitor classes, making early regional alliances, technology transfer, and localized manufacturing attractive levers to secure pricing and formulary advantages. Policy-level drivers include progressive reimbursement expansion for CKD therapies, government focus on non-communicable disease management, and openness to innovative oral agents that reduce hospitalization and procedure volumes. Cancer-related anemia is likely to be more relevant in advanced oncology markets such as Japan, South Korea, and Australia, where upgraded supportive care pathways can support selective introduction of Vadadustat; however, CKD anemia will remain the primary growth engine, suggesting a strategic focus on nephrology-led positioning first, followed by targeted oncology collaborations in high-income Asia-Pacific submarkets.
Market Dynamics and Supply Chain
01
Driver: Growing Global Burden of Chronic Kidney Disease and the Shift Toward Oral Anemia Therapies
A major driver for the vadadustat market is also the rising prevalence of chronic kidney disease worldwide coupled with an industry-wide shift toward convenient oral anemia treatments. CKD incidence is also increasing due to aging populations and higher rates of diabetes and hypertension, expanding the pool of patients suffering from CKD-associated anemia and creating significant unmet treatment needs. As CKD becomes more common, healthcare systems are also looking for therapies that improve patient outcomes while reducing the burden of care. Separately, there is also a clear trend toward oral hypoxia-inducible factor prolyl hydroxylase inhibitors like vadadustat as a preferred alternative to traditional injectable erythropoiesis-stimulating agents because oral pills enhance patient convenience, reduce clinic visits, and support better adherence. The combined effect of a growing disease burden and demand for easy-to-administer treatments is also a powerful catalyst expanding vadadustat adoption in the nephrology anemia segment.
Another key driver is also the expansion of regulatory approvals and reimbursement coverage for vadadustat across multiple countries, which improves market access and patient uptake. Vadadustat has also gained authorization in many regions for treating anemia in adults with CKD, including dialysis-dependent populations, helping it penetrate diverse healthcare markets and broaden its clinical use. Regulatory decisions that secure inclusion on formularies and reimbursement lists directly influence physician prescribing behavior by making treatment more affordable and reducing financial barriers for patients. As governments and payers recognize the value of oral HIF-PHIs compared with older therapies, wider coverage encourages hospitals and clinics to adopt vadadustat, boosting its integration into standard care pathways and enhancing overall market growth.
02
Restraint: Regulatory Safety Concerns and Inconsistent Approval Decisions Impede Market Expansion
A primary restraint for vadadustat’s market growth is persistent regulatory safety concerns and inconsistent approval decisions across key regions, which directly impact adoption and revenue potential. Although the drug has achieved regulatory approvals in many countries for dialysis-dependent CKD anemia, it faced significant setbacks with safety evaluations, particularly related to cardiovascular risk in non-dialysis patients, leading to delays, additional data requirements, or restricted indications. These safety hesitations have slowed uptake by clinicians and payers, who prefer well-characterized benefit-risk profiles, and limited inclusion on formularies. For example, regulators have required extra studies or narrower labels compared with competing therapies, reducing vadadustat’s potential addressable market and contributing to slower demand versus expectations.
03
Opportunity: Expanding Vadadustat use for non-dialysis CKD anemia in emerging Asia and Collaborative Vadadustat programs with global dialysis networks targeting high-risk anemia patients
Emerging Asian markets have rapidly growing chronic kidney disease populations with limited access to advanced renal anemia management and injectable agents. Vadadustat, as an oral HIF-PH inhibitor, can address unmet needs in non-dialysis CKD patients who require flexible, outpatient anemia control. Payers and health systems favor cost-effective treatment that reduces clinic visits and supports home-based monitoring. Within this opportunity, the 450 mg Vadadustat dosage is expected to grow fastest, with global revenue rising from $142.56 million in 2025 to $205.61 million by 2030.
Global dialysis providers are seeking innovative oral anemia therapies that integrate smoothly into hemodialysis protocols and reduce injection burden. Collaborative Vadadustat programs, including structured risk-sharing agreements and real-world outcome studies, can differentiate the brand against traditional agents. Technology-enabled adherence monitoring and nephrology clinic partnerships will be essential to demonstrate hemoglobin control. In this segment, the 300 mg Vadadustat strength is poised for robust uptake, with global revenue increasing from $43.10 million in 2025 to $60.12 million by 2030, reflecting a CAGR of 6.88%.
04
Challenge: Intense Competition from Established Anemia Treatments and HIF-PHI Alternatives Limits Market Share Growth
Another significant market restraint is intense competition from well-established erythropoiesis-stimulating agents and other HIF-PHIs, which limits vadadustat’s ability to capture broader share despite its oral formulation. Traditional injectable ESAs remain widely accepted in clinical practice with long histories of use, while rival oral HIF-PH inhibitors like roxadustat also compete strongly in several key markets. This competitive environment constrains vadadustat’s pricing power and physician preference, with some clinicians favoring alternatives perceived to have more robust data or differentiated profiles. As a result, demand behavior skews toward incumbents with larger installed bases, pressuring vadadustat’s overall market penetration and revenue growth.
Supply Chain Landscape
1
Vadadustat Synthesis
Akebia Therapeutics Inc.Otsuka Pharmaceutical Co. Ltd.Cambrex Corporation
2
HIF-PH API
Akebia Therapeutics Inc.Otsuka Pharmaceutical Co. Ltd.Siegfried Holding AG
3
Oral Drug Formulation
Akebia Therapeutics Inc.Otsuka Pharmaceutical Co. Ltd.Catalent Inc
4
CKD Anemia Therapy
Nephrology clinicsDialysis centersHospital pharmacies
1
Vadadustat Synthesis
Akebia Therapeutics Inc.Otsuka Pharmaceutical Co. Ltd.Cambrex Corporation
2
HIF-PH API
Akebia Therapeutics Inc.Otsuka Pharmaceutical Co. Ltd.Siegfried Holding AG
3
Oral Drug Formulation
Akebia Therapeutics Inc.Otsuka Pharmaceutical Co. Ltd.Catalent Inc
4
CKD Anemia Therapy
Nephrology clinicsDialysis centersHospital pharmacies
Use Cases of Vadadustat in CKD Anemia & Cancer-related Anemia
CKD Anemia : Vadadustat is an oral hypoxia-inducible factor prolyl hydroxylase inhibitor (HIF-PHI) primarily used to treat anemia associated with chronic kidney disease (CKD), particularly in adults undergoing long-term dialysis. It works by stabilizing hypoxia-inducible factors to increase the body’s endogenous erythropoietin production and improve iron availability, raising hemoglobin levels in patients with renal anemia. This oral administration provides an advantage over traditional injectable erythropoiesis-stimulating agents, potentially improving patient adherence and convenience. Key market players include Akebia Therapeutics and Otsuka Pharmaceutical, which have developed and commercialized vadadustat under the brand name Vafseo in multiple countries, strengthening their nephrology portfolios and addressing a substantial unmet need in CKD-related anemia management. The drug’s approval in the United States, European Union, and Japan has expanded its global footprint and competitive position relative to other HIF-PHIs.
Cancer-related Anemia : While vadadustat’s primary approved indication is CKD-related anemia, its mechanism of stimulating erythropoiesis suggests potential utility in other anemia types, including cancer-related anemia that arises from chronic disease or treatment-induced erythropoietin suppression. However, there are currently no specific regulatory approvals or strong clinical evidence supporting vadadustat’s use for cancer-related anemia. In clinical practice, cancer-associated anemia is more often addressed with erythropoiesis-stimulating agents such as darbepoetin alfa. Theoretical research on HIF modulation hints at broader roles in hypoxia-related conditions, but vadadustat’s application outside CKD remains investigational. Consequently, firms like Akebia focus their development and marketing efforts on CKD indications, leaving cancer-related anemia as a potential future research frontier rather than a current market application.
Recent Developments
Recent developments for vadadustat highlight its expanding role in CKD anemia management and growing emphasis on oral HIF-PH inhibitors as viable alternatives to traditional injectable erythropoiesis-stimulating agents. Regulatory approvals across major markets and enhanced reimbursement coverage are driving broader adoption, although safety signal evaluations continue to shape label indications. A key trend is the integration of precision therapy and real-world evidence in anemia treatment decisions, reinforcing vadadustat’s value proposition in personalized renal care pathways.
October 2024 : Akebia Therapeutics signed a multi-year commercial supply contract with one of the largest U.S. kidney care and dialysis organizations, expanding access to Vafseo for patients on dialysis at more than 2,000 centers nationwide. This agreement supports the planned U.S. availability of the product beginning in January 2025 and broadens physician prescribing and distribution reach.
January 2025 : Akebia Therapeutics announced multiple positive business updates including new commercial supply agreements covering nearly 100 percent of U.S. dialysis patients, shipment of Vafseo tablets to dialysis centers, and plans to initiate a Phase 3 study to potentially expand indications beyond dialysis patients, strengthening its commercial presence.
October 2024 : Akebia Therapeutics extended its supply agreement with STA Pharmaceutical Hong Kong Ltd., amending the original contract to secure long-term manufacturing of vadadustat through 2032 with revised pricing provisions, supporting sustained supply for global commercial launch and mitigating supply chain risks.
Impact of Industry Transitions on the Vadadustat Market
As a core segment of the Pharmaceutical industry,
the Vadadustat market develops in line with broader industry shifts.
Over recent years, transitions such as From EPO based Anemia Treatments to HIFPHI Therapies and Advancements in Personalized Medicine Personalized Medicine Revolution have redefined priorities
across the Pharmaceutical sector,
influencing how the Vadadustat market evolves in terms of demand, applications and competitive dynamics.
These transitions highlight the structural changes shaping long-term growth opportunities.
01
From EPO based Anemia Treatments to HIFPHI Therapies
The accelerating shift from EPO-based anemia treatments to HIF-PHI therapies is structurally reshaping the Vadadustat market, as end-user companies in chronic kidney disease increasingly favor hypoxia-inducible factor prolyl hydroxylase inhibitor mechanisms for renal anemia management. This transition reflects a strategic move toward oral anemia therapy options that offer differentiated profiles in cardiovascular risk reduction and potential mitigation of dialysis dependence, strengthening Vadadustat’s positioning within the nephrology market. As adoption deepens between 2025 and 2030, this therapy migration is projected to generate an incremental USD 12 million for the Vadadustat industry, signaling not only growing clinical confidence but also a meaningful expansion of the addressable revenue pool. Collectively, these dynamics confirm Vadadustat as a pivotal HIF-PHI therapy in the evolving chronic kidney disease anemia treatment landscape.
02
Advancements in Personalized Medicine Personalized Medicine Revolution
The shift toward personalized medicine has significantly influenced the clinical and commercial trajectory of vadadustat, reflecting a broader transformation in anemia management. By activating the hypoxia-inducible factor pathway, vadadustat aligns with individualized treatment approaches that consider patient-specific erythropoietin response, iron metabolism, and disease stage. This transition enables clinicians to tailor therapy for chronic kidney disease patients who respond poorly to conventional erythropoiesis-stimulating agents. The impact extends beyond pharmaceuticals into diagnostic and digital health industries, where biomarker testing and patient monitoring tools support optimized dosing and risk assessment. Contract research organizations and renal care providers also benefit from data-driven treatment protocols, illustrating how personalized medicine is reshaping interconnected healthcare ecosystems through targeted, mechanism-based therapies like vadadustat.