TreatmentTrends: Dry/Wet Age-Related Macular Degeneration 2015 (EU) is the fourth annual syndicated report that offers a snapshot of dry and wet age-related macular degeneration (AMD) market dynamics and the competitive landscape through comprehensive primary research with retinal specialists and general ophthalmologists across the major European markets (EU5; France, Germany, Italy, Spain, and the United Kingdom) who personally administer anti-vascular endothelial growth factor (VEGF) injections. The report covers the current and anticipated use of intravitreal injections, in particular the anti-VEGF agents (, Roche’s Avastin [bevacizumab], Bayer HealthCare’s Eylea [aflibercept], and Novartis’s Lucentis [ranibizumab]), in the treatment of wet AMD. We also assess surveyed physicians’ perceptions of these wet AMD products—, their advantages and disadvantages, typical patient types, barriers to growth—and current detailing and messaging efforts for approved wet AMD brands. Respondents are asked about their awareness of products in development for geographic atrophy (GA) or wet AMD and anticipated integration of these products in the treatment algorithm, as well as the potential for biosimilars in the wet AMD market.

Questions Answered in This Report:

  • While there are no approved therapies for the treatment of GA associated with dry AMD, treatment rates with intravitreal anti-VEGF therapies are high across the EU5 markets. How are patients with wet AMD and different forms of dry AMD (i.e., early, intermediate, GA) being managed and treated in each EU5 country? How has the treatment algorithm (e.g., line of therapy, typical patient type) changed compared with the previous four years? Is treatment anticipated to change over the next six months? What factors are driving these anticipated changes and how do they differ by country?

  • Eylea, approved in November 2012, offers the potential for less-frequent dosing compared with Lucentis and off-label Avastin. What product attributes are most important to physicians when they select a specific wet AMD therapy? How do physicians believe the current anti-VEGF agents perform on each attribute and against each other? How has brand performance changed compared with the previous years? What messaging efforts are Novartis and Bayer HealthCare employing to differentiate their product?

  • Multiple therapies are in mid- to late-stage development for the treatment of GA (e.g., lampalizumab, emixustat hydrochloride) and wet AMD (e.g., Fovista, abicipar pegol, OHR-102 (squalamine), and RTH-258). How familiar are physicians in each of the EU5 countries with these products? Which products do they perceive as offering the most value and what characteristics drive the value? How might patient characteristics impact the commercial attractiveness of emerging therapies? Where do ophthalmologists expect emerging therapies to fit in the GA or wet AMD treatment algorithm? Will adjunctive therapies play a role in first-line therapy or be reserved for treatment-resistant patients? How will biosimilars be incorporated into the treatment algorithm and how does this differ, if at all, between EU5 countries? What current products are most at risk by the potential launches of pipeline products and biosimilars?

Scope:

Markets covered: Europe (France, Germany, Italy, Spain, and the United Kingdom).

Primary research: 231 retinal specialists and general ophthalmologists.

Indication coverage: Early dry AMD, intermediate dry AMD, GA associated with dry AMD, and wet AMD.

Emerging therapies: Phase II: 1 drug; Phase III: 5 drugs.

Author(s): Sarah Soucy, M.S.

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