In 2005, in addition to growing Renagel, we gained a marketed product for chronic kidney disease and accelerated development programs for other renal therapies.

Growth of Renagel
As a first-line therapy for controlling phosphorus levels in patients with kidney disease who are on hemodialysis, Renagel continues to grow steadily, with sales increasing by 14 percent in 2005. There is much opportunity to help patients - worldwide, approximately 1.3 million patients are on hemodialysis, and over 20 percent of those in the United States are estimated to die each year. Approximately 350,000 patients are currently on Renagel, which is marketed in 50 countries.

Renagel's long-term growth will continue to come from several key factors, including increased patient access and reimbursement, geographical expansion, and new marketing programs. We also expect the data from our DCOR post-marketing study of Renagel, which showed reduction in mortality and reduced numbers and lengths of hospital stays among Renagel patients, to help drive future growth. The DCOR study is the first large-scale, prospective, randomized clinical trial to demonstrate such benefits. The study showed that the use of Renagel reduced mortality in two groups of patients, those who were treated for two years or more, and those who were 65 years of age or older. In addition, Renagel use reduced both the number of hospitalizations and length of hospital stays, and these data are expected to contribute to a better understanding of the pharmaco-economic advantages of Renagel use.

On January 1, 2006, the Medicare Part D oral drug benefit took effect, making Medicare-covered access to Renagel more widely available. While it is not possible to gauge the exact impact at this time, Renagel is well-positioned on the large majority of Medicare formularies. This favorable position is due not only to Renagel's clinical benefits but also to the Renagel REACH initiative that we put in place to help Medicare beneficiaries gain access in advance of the new benefit. Genzyme continues to offer the Renassist program as a resource to help patients get access to Renagel through their existing health insurance plans.

The impact of Hectorol
Genzyme's 2005 acquisition of Bone Care International brought us the marketed product Hectorol, which is used in the large chronic kidney disease market and works together with Renagel in patients on hemodialysis. Like Renagel, Hectorol is included in the majority of Medicare drug plans. Currently available in North America, Hectorol has great potential around the world, and we are actively pursuing international registrations.

Broad commitment to renal disease
We are committed to treating chronic kidney disease (CKD) at all stages, a commitment reinforced by the addition of Hectorol to our portfolio. We are investigating the use of sevelamer carbonate in CKD patients. We began a study of a tablet formulation in CKD patients in late 2005 and will initiate another of a powder formulation in the first half of 2006. There are one million CKD patients in the United States alone, an estimated 600,000 to 700,000 of whom may benefit from this treatment. We also initiated a trial of a powder formulation of sevelamer carbonate among hemodialysis patients at the end of 2005. Additionally, we are in clinical studies with a cell therapy approach to treat acute renal failure.