Anti-vascular endothelial growth factor (VEGF) therapy is the standard of care for treating wet age-related macular degeneration (AMD), with several commercially available options. The continued strong uptake of Eylea in Europe threatens Lucentis’s historical position as the patient-share leader in this market, while use of off-label Avastin differs across the EU5 countries. Additionally, with no currently available treatments, there is commercial opportunity for first-to-market dry AMD therapies. The Age-Related Macular Degeneration Current Treatment Overview provides a synopsis of current treatment goals, key therapies, and medical practice in the G7 markets. The detailed, expanded analysis in Dry and Wet Age-Related Macular Degeneration Current Treatment EU offers a snapshot of how EU5 ophthalmologists are currently managing their dry and wet AMD patients, with a particular focus on the use of anti-VEGF for wet AMD, as well as insight into the factors driving such prescribing habits.

Table of contents

  • Dry And Wet Age-Related Macular Degeneration - Current Treatment - Detailed Expanded Analysis (EU)
    • Physician Prescribing Practices
      • Key Findings
      • Patient Characteristics
        • AMD Represents a High Disease Burden Given the Frequent Occurance of Bilateral Disease
        • Unilateral vs. Bilateral AMD Involvement Among GA Patients (Survey Data)
        • Unilateral vs. Bilateral AMD Involvement Among Wet AMD Patients (Survey Data)
        • Lesion Type Among Wet AMD Patients (Survey Data)
        • Treatment Response Among IVT Pharmacotherapeutically-Treated Wet AMD Patients (Survey Data)
      • Treatment Practices
        • Anti-VEGF Therapy Prevails as the Cornerstone of Wet AMD Treatment
        • IVT Pharmacotherapy Continues to Be the Primary Treatment Approach for Wet AMD in the EU5
        • Changes in Treatment Approaches for AMD Disease Types: Year Over Year (Survey Data)
        • Current Treatment Approaches for Early and Intermediate Dry AMD Patients by Country (Survey Data)
        • Current Treatment Approaches for GA and Wet AMD Patients by Country (Survey Data)
        • Recent IVT Pharmacotherapy Treatment Initiation Among Wet AMD Patients (Survey Data)
        • Subretinal Fibrosis Prevalence Among IVT Pharmacotherapeutically-Treated Wet AMD Patients (Survey Data)
        • Bilateral IVT Pharmacotherapy Treatment for Wet AMD Patients by Country (Survey Data)
        • Eylea Patient Share Continues to Gain Ground in the Wet AMD Market
        • Current Prescriber Base for IVT Pharmacotherapy Brands to Treat Wet AMD by Country (Survey Data)
        • Current IVT Pharmacotherapy Patient Share for Wet AMD: Year Over Year (Survey Data)
        • Current Avastin Patient Share for Wet AMD by Country: Year Over Year (Survey Data)
        • Current Eylea Patient Share for Wet AMD by Country: Year Over Year (Survey Data)
        • Current Lucentis Patient Share for Wet AMD by Country: Year Over Year (Survey Data)
        • Current Patient Share Among IVT Pharmacotherapeutically-Treated Wet AMD Patients by Country (Survey Data)
        • No Differences Are Seen Between Number of Injections of Lucentis and Eylea Prior to Discontinuation
        • Average Number of Injections Wet AMD Patients Receive Prior to Discontinuation of Therapy (Survey Data)
        • Nonpharmacological Treatment Approaches Are Limited to Subpopulations of AMD Patients
        • AREDS Recommendations by AMD Disease Type and Country (Survey Data)
        • The Majority of IVT Pharmacotherapeutically-Treated Wet AMD Patients Are on Early-Line Anti-VEGF Therapies
        • Most Wet AMD Patients are on Early-Line Therapy in the EU5
        • Current Line of Therapy Allocation Among Wet AMD Patients by Country (Survey Data)
        • Wet AMD Patients With Insufficient Responses to Anti-VEGF Agents Progress Quickly Between Lines of Therapy
        • Months Between Line of Therapy Progression for Wet AMD Patients: Total EU5 (Survey Data)
        • Progression from First-Line to Second-Line Therapy by Country (Survey Data)
        • Progression from Second-Line to Third-Line Therapy by Country (Survey Data)
        • Anti-VEGF Agents Are the Preferred Therapies Among the First Three Lines of Therapy for Wet AMD
        • Treatment Approach by Line of Therapy for Wet AMD by Country (Survey Data)
        • Polypharmacy Plays a Small Role in IVT Pharmacotherapy for Wet AMD
        • Adjunctive Therapy Use Among Wet AMD Patients Treated with IVT by Country (Survey Data)
      • Persistency and Compliance
        • Wet AMD Patients in the EU5 Countries Maintain High Levels of Persistency and Compliance
        • One-Year Anti-VEGF Brand Persistence Among Wet AMD Patients by Country (Survey Data)
        • Anti-VEGF Brand Compliance Among Wet AMD Patients by Country (Survey Data)
      • Sequencing of Treatment
        • Wet AMD Patients Switching Off of Lucentis Most Often Move to Eylea
        • Pathways to Initiation of Anti-VEGF Brands for Wet AMD Patients in the Past Year: Total EU5 (Survey Data)
        • Pathways to Initiation of Avastin for Wet AMD Patients in the Past Year by Country (Survey Data)
        • Pathways to Initiation of Eylea for Wet AMD Patients in the Past Year by Country (Survey Data)
        • Pathways to Initiation of Lucentis for Wet AMD in the Past Year by Country (Survey Data)
        • Treatment Flow of Wet AMD Patients Discontinuing Anti-VEGF Therapy in the Past Year: Total EU5 (Survey Data)
        • Treatment Flow of Wet AMD Patients Discontinuing Avastin in the Past Year by Country (Survey Data)
        • Treatment Flow of Wet AMD Patients Discontinuing Eylea in the Past Year by Country (Survey Data)
        • Treatment Flow of Wet AMD Patients Discontinuing Lucentis in the Past Year by Country (Survey Data)
      • Recent/Anticipated Changes in Brand Usage/Treatment Approach
        • Eylea's Wet AMD Patient Share Is Expected to Continue to Increase One Year From Now
        • Change in Anti-VEGF Brand Use in Wet AMD Patients Over the Past Year: EU5 Total (Survey Data)
        • Current vs. Anticipated Changes in Treatment Approach for Early Dry AMD: EU5 Total (Survey Data)
        • Current vs. Anticipated Changes in Treatment Approach for Intermediate Dry AMD: EU5 Total (Survey Data)
        • Current vs. Anticipated Changes in Treatment Approach for GA: EU5 Total (Survey Data)
        • Current vs. Anticipated Changes in Treatment Approach for Wet AMD: EU5 Total (Survey Data)
        • Anticipated IVT Pharmacotherapy Patient Share for Wet AMD One Year from Now: EU5 Total (Survey Data)
    • Physician Insight on Medical Practice
      • Key Findings
      • Drivers of Treatment Selection
        • Efficacy and Reimbursement Regulations Drive Wet AMD Treatment Selection
        • EU5 Opthalmologists Focus on Efficacy Reasons for Driving Treatment Initiation in Wet AMD Patients
        • Reasons for Initiation of Anti-VEGF Therapy in Wet AMD Patients by Country (Survey Data)
        • Reimbursement Practices Are Drivers of Anti-VEGF Brand Usage
        • Availability of Anti-VEGF Brands for Wet AMD by Country (Survey Data)
        • Sample and Voucher Access for Eylea and Lucentis by Country (Survey Data)
        • Channels for Anti-VEGF Brand Availability for Wet AMD by Country (Survey Data)
        • Reimbursement Practices in the EU5 for Off-Label Avastin Use in Wet AMD (Survey Data)
        • Reimbursement Practices for Off-Label Avastin Use in Wet AMD by Country (Survey Data)
        • Factors That Drive Prescribing of Anti-VEGF Agents for Wet AMD by Brand (Survey Data)
        • Frequency of Dosing of Anti-VEGF Brands for Wet AMD After Initial Six Months: Total EU5 (Survey Data)
        • Frequency of Avastin Dosing for Wet AMD After First Six Months by Country (Survey Data)
        • Frequency of Eylea Dosing for Wet AMD After First Six Months by Country (Survey Data)
        • Frequency of Lucentis Dosing for Wet AMD After First Six Months by Country (Survey Data)
        • Reasons for Increased Use of Anti-VEGF Brands Among Wet AMD Patients in the EU5 (Survey Data)
        • Likely Scenarios for Initiating Therapy in Wet AMD Patients by Treatment Approach: EU5 Total (Survey Data)
        • Likely Scenarios for Initiating Avastin in Wet AMD Patients by Country (Survey Data)
        • Likely Scenarios for Initiating Eylea in Wet AMD Patients by Country (Survey Data)
        • Likely Scenarios for Initiating Lucentis in Wet AMD Patients by Country (Survey Data)
        • Avastin's Lack of EMA Approval for Wet AMD Is a Major Obstacle to Use
        • Reasons for Decreased Use of Anti-VEGF Brands Among Wet AMD Patients in the EU5 (Survey Data)
        • Number of Injections Per Year in Wet AMD Patients by Anti-VEGF Agent: EU5 Total (Survey Data)
        • Number of Avastin Injections Per Year in Wet AMD Patients by Country (Survey Data)
        • Number of Eylea Injections Per Year in Wet AMD Patients by Country (Survey Data)
        • Number of Lucentis Injections Per Year in Wet AMD Patients by Country (Survey Data)
        • Obstacles to Using More Anti-VEGF Agents in Practice for Wet AMD Patients: EU5 Total (Survey Data)
        • Obstacles to Using More Avastin in Practice for the Treatment of Wet AMD by Country (Survey Data)
        • Obstacles to Using More Eylea in Practice for the Treatment of Wet AMD by Country (Survey Data)
        • Obstacles to Using More Lucentis in Practice for the Treatment of Wet AMD by Country (Survey Data)
        • Primary Reasons for Switching to Eylea or Lucentis Are Similar in Wet AMD
        • Reasons for Switching OFF Anti-VEGF Brands in Wet AMD Patients in the Past Year: EU5 Total (Survey Data)
        • Reasons for Switching OFF Anti-VEGF Brands in Wet AMD Patients in the Past Year: France (Survey Data)
        • Reasons for Switching OFF Anti-VEGF Brands in Wet AMD Patients in the Past Year: Germany (Survey Data)
        • Reasons for Switching OFF Anti-VEGF Brands in Wet AMD Patients in the Past Year: Italy (Survey Data)
        • Reasons for Switching OFF Anti-VEGF Brands in Wet AMD Patients in the Past Year: Spain (Survey Data)
        • Reasons for Switching OFF Anti-VEGF Brands in Wet AMD Patients in the Past Year: United Kingdom (Survey Data)
        • Reasons for Switching TO Anti-VEGF Brands in Wet AMD Patients in the Past Year: EU5 Total (Survey Data)
        • Reasons for Switching TO Anti-VEGF Brands in Wet AMD Patients in the Past Year: France (Survey Data)
        • Reasons for Switching TO Anti-VEGF Brands in Wet AMD Patients in the Past Year: Germany (Survey Data)
        • Reasons for Switching TO Anti-VEGF Brands in Wet AMD Patients in the Past Year: Italy (Survey Data)
        • Reasons for Switching TO Anti-VEGF Brands in Wet AMD Patients in the Past Year: Spain (Survey Data)
        • Reasons for Switching TO Anti-VEGF Brands in Wet AMD Patients in the Past Year: United Kingdom (Survey Data)
        • Advanced Anti-VEGF-Resistant Disease Drives Therapy Discontinuation in Wet AMD Patients
        • Reasons for Patients Discontinuing All Anti-VEGF Treatment Within the Past Year by Country (Survey Data)
        • Advanced Disease/Fibrosis Is the Most Common Reason for More Wet AMD Patients Not Receiving Anti-VEGF Therapy
        • Reasons Why More Wet AMD Patients Do Not Receive Anti-VEGF Therapy by Country (Survey Data)
      • Face-to-Face Product Detailing Effectiveness
        • Eylea and Lucentis Sales Representatives Elicit Similar Satisfaction Scores Among Recently Detailed Ophthalmologists
        • Detailing Frequency and Reach for Wet AMD Is Similar for Eylea and Lucentis
        • Sales Representative Access to Ophthalmologists in Clinical Settings by Country (Survey Data)
        • Reach of Sales Representatives for Wet AMD Brands (Survey Data)
        • Physician Contact With Sales Representatives for Wet AMD Brands Within the Past Month by Country (Survey Data)
        • Physician Contact With Sales Representatives for Wet AMD Brands Within the Past Month: Year Over Year (Survey Data)
        • Frequency of Sales Representative Visits for Wet AMD Brands in the Past Six Months: EU5 Total (Survey Data)
        • Ophthalmologists Are Satisfied with Eylea and Lucentis Sales Representatives' Detailing Visits
        • Recently Detailed Ophthalmologists' Satisfaction Ratings with Sales Representatives for Eylea and Lucentis (Survey Data)
        • Similar Messages Are Recalled by Ophthalmologists from Recent Eylea and Lucentis Details for Wet AMD
        • Topics Recalled from Recent Details on Eylea and Lucentis for Wet AMD (Survey Data)
    • Methodology
      • Primary Market Research Methodology
      • Number of Patients Diagnosed with AMD Forms Currently Under Personal Management of Surveyed Ophthalmologists by Country (Survey Data)
      • Physician Demographics by Country (Survey Data)
      • General Ophthalmologists Who Consider Themselves Retinal Specialists in the EU5 (Survey Data)
      • Primary Practice Types Among Surveyed Ophthalmologists by Country (Survey Data)
    • Appendix
      • Primary Market Research
        • Factors That Drive Prescribing of Avastin for Wet AMD Treatment by Country (Survey Data)
        • Factors That Drive Prescribing of Eylea for Wet AMD Treatment by Country (Survey Data)
        • Factors That Drive Prescribing of Lucentis for Wet AMD Treatment by Country (Survey Data)
        • Treatment Flow of Wet AMD Patients Who Have Discontinued Anti-VEGF Therapy: France (Survey Data)
        • Treatment Flow of Wet AMD Patients Who Have Discontinued Anti-VEGF Therapy: Germany (Survey Data)
        • Treatment Flow of Wet AMD Patients Who Have Discontinued Anti-VEGF Therapy: Italy (Survey Data)
        • Treatment Flow of Wet AMD Patients Who Have Discontinued Anti-VEGF Therapy: Spain (Survey Data)
        • Treatment Flow of Wet AMD Patients Who Have Discontinued Anti-VEGF Therapy: United Kingdom (Survey Data)
        • Reasons for Switching TO Avastin in Wet AMD by Country (Survey Data)
        • Reasons for Switching TO Eylea in Wet AMD by Country(Survey Data)
        • Reasons for Switching TO Lucentis in Wet AMD by Country (Survey Data)
        • Months Between Progression of Lines of Therapy for Wet AMD Patients: France (Survey Data)
        • Months Between Progression of Lines of Therapy for Wet AMD Patients: Germany (Survey Data)
        • Months Between Progression of Lines of Therapy for Wet AMD Patients: Italy (Survey Data)
        • Months Between Progression of Lines of Therapy for Wet AMD Patients: Spain (Survey Data)
        • Months Between Progression of Lines of Therapy for Wet AMD Patients: United Kingdom (Survey Data)

Author(s): Sarah Soucy

Sarah Soucy, M.S., is a Business Insights Analyst with the central nervous system/ophthalmology disorders group at Decision Resources Group. She has authored primary research and insights for dry and wet age-related macular degeneration and multiple sclerosis.

Prior to joining DRG, Ms. Soucy spent six years on the client side as a scientist at Pfizer in the inflammation and immunology research group with both in vitro and in vivo experience. She earned her B.S. in Animal Science with a Bioscience and Technology option and her M.S. in Nutritional Sciences from the University of New Hampshire, Durham, where she studied disordered metabolism


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