Getting a drug approved for commercial use is difficult. For biotech companies, that isn’t the full extent of the challenge. This can be seen in fourth-quarter results of Keryx Biopharmaceuticals, which makes a phosphate binder used in treating chronic kidney disease. Its drug, Auryxia, generated great excitement. From the start of 2013 through the Food and Drug Administration’s approval of Auryxia on Sept.

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