“TreatmentTrends: Dry/Wet Age-Related Macular Degeneration 2014 (EU)” is the third annual syndicated report that offers a snapshot of dry and wet age-related macular degeneration (AMD) market dynamics and competitive landscape through comprehensive primary research with retinal specialists across the major European markets (EU5; France, Germany, Italy, Spain, and the United Kingdom). The report covers the current and anticipated use of intravitreal injections, in particular the anti-vascular endothelial growth factor (VEGF) agents (i.e., Roche’s Avastin [bevacizumab], Bayer HealthCare’s Eylea [aflibercept], and Novartis’s Lucentis [ranibizumab]), in the treatment of wet AMD, as well as surveyed retinal specialists’ perceptions of these products—e.g., their advantages and disadvantages, ideal patient types, barriers to growth, and promotional activity. Respondents are also queried on their interest in and willingness to prescribe biosimilar bevacizumab and biosimilar ranibizumab for wet AMD and their awareness of and anticipated use of therapies in development for dry and wet AMD.

Questions Answered in This Report:

  • While there are no approved therapies for the treatment of dry AMD, multiple anti-VEGF agents are available for the treatment of wet AMD. How are patients across AMD disease classifications (early dry AMD, intermediate dry AMD, geographic atrophy, and wet AMD) currently being managed and treated in each EU5 country? How has the treatment algorithm changed over the past three years? Is treatment anticipated to change over the next six months? What factors are driving these anticipated changes?

  • Although Avastin is not approved for the treatment of wet AMD, it is often compounded and used off-label for the disease because of its low price relative to the approved anti-VEGF agents. Authorities in France and Italy recently voted in favor of reimbursing off-label use of Avastin for wet AMD for economic reasons. How does prescribing of Avastin for wet AMD and perceptions related to the agent differ, if at all, between the EU5 countries? Is use of the agent anticipated to change over the next six months? Do retinal specialists in Germany, Spain, and the United Kingdom anticipate similar legislation being passed by authorities in their countries?

  • Eylea gained approval for the treatment of wet AMD in November 2012 and offers the potential for less-frequent dosing. How has Eylea been incorporated into the wet AMD treatment algorithm given the different market access issues in each of the EU5 countries? How has its availability affected the use of other therapies for wet AMD, particularly the other anti-VEGF agents Avastin and Lucentis? Have perceptions of Eylea changed over the past year and do these perceptions differ between countries?

  • Biosimilar ranibizumab could offer a low-priced alternative to Lucentis. How interested are retinal specialists in learning more about biosimilar ranibizumab? How willing are they to prescribe it to wet AMD patients across the treatment algorithm?

  • Multiple products are in mid- to late-stage clinical development for the treatment of dry and wet AMD, including lampalizumab and emixustat hydrochloride for dry AMD and Fovista, abicipar pegol, sonepcizumab, and Squalamine for wet AMD. How familiar are retinal specialists in each of the EU5 countries with these products and has familiarity changed since previous years? Which products are believed to offer the most value in the treatment of dry and wet AMD and what drives these perceptions? Where do retinal specialists expect emerging therapies for wet AMD to fit in the treatment algorithm?

Scope:

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

Primary research: 224 country-specific interviews with retinal specialists.

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

Emerging therapies: Phase II: 4 drugs; Phase III: 2 drugs.

Author(s): Emma McFadden, Ph.D.

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