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Coming June 2018
Vascular endothelial growth factor ( VEGF ) inhibitors—approved agents Eylea (Regeneron) and Lucentis (Roche/Genentech) and off-label Avastin (Roche/Genentech)—are the treatment mainstays for diabetic macular edema ( DME ). Allergan’s Ozurdex and Alimera Sciences’ Iluvien, two long-acting corticosteroid implants, are also used to treat DME . The market heated up in April 2017 when the label of Lucentis mg was expanded to treat patients with diabetic retinopathy ( DR ) without DME . Factoring in the anticipated approval of Eylea for nonproliferative DR patients without DME in the United States, as well as the expected availability of biosimilars of Lucentis mg and Eylea and emerging therapies for DME , this report delivers actionable insights to help companies best position their DME / DR products to succeed in the access and reimbursement environment.
Does coverage of therapies for DME differ on MCO s’ largest Medicare Advantage and commercial insurance plans? How do various cost-control measures impact prescribing of current therapies for DME ?
How do pharmacoeconomic/health economic outcomes data impact formulary decision making for drugs for DME ?
Do physicians expect to prescribe the emerging therapies abicipar pegol (Allergan), Luminate (Allegro Ophthalmics), and RG-7716 (Roche) to their DME patients? What factors would influence preferred coverage of these agents on the MCO s’ largest risk-based commercial plans?
How is the expected availability of biosimilars of Lucentis mg and Eylea likely to impact access to and reimbursement of the originator branded therapies for DME ?
Access & Reimbursement provides in-depth insight regarding the impact of payer policy on physician prescribing behavior so you can build your market access strategy and optimize your brand positioning.
Markets covered: United States
Survey of ~100 ophthalmologists/retinal specialists in the United States
Survey of ~30 managed care organizations ( MCO ) pharmacy and medical directors ( PD s/ MD s)
Key companies: Roche/Genentech, Regeneron, Alimera Sciences, Allergan, Allegro Ophthalmics
Key drugs: Avastin, Eylea, Lucentis, Iluvien, Ozurdex, RG-7716, Luminate, abicipar pegol
Reimbursement and contracting
Access and prescribing
Opportunities and challenges for emerging therapies