TreatmentTrends: Diabetic Retinopathy/Diabetic Macular Edema (EU) is the inaugural report in an annual syndicated report series that offers a snapshot of the diabetic retinopathy (DR) and diabetic macular edema (DME) market dynamics and competitive landscape through comprehensive primary research with retinal specialists and general ophthalmologists in each of the EU5 countries (France, Germany, Italy, Spain, United Kingdom). The report provides valuable insight into the current and anticipated treatment of patients with DR (including nonproliferative DR [NPDR] and proliferative DR [PDR]) and DME (including focal and diffuse), with a particular focus on the use of intravitreal pharmacotherapy, specifically anti-vascular endothelial growth factor (VEGF) agents and long-acting corticosteroid implants. We also assess surveyed physicians’ perceptions of these products for DME—e.g., their advantages and disadvantages, ideal patient types, barriers to growth—and current detailing and messaging efforts for approved DME brands. Finally, respondents are queried about their awareness of and interest in products in development DME.

Questions Answered in This Report:

  • Although no therapies have been approved to treat DR exclusive of DME, multiple agents are available to treat DME (including some off-label use of these agents for DR). How are patients with different subtypes of DR (NPDR, PDR) and DME (focal and diffuse) currently being managed and treated? Is treatment anticipated to change over the next six months? What factors are driving these anticipated changes? Does current and anticipated treatment differ across the EU5 countries?

  • Eylea and Ozurdex gained expanded labeling in 2014 to include DME, while Iluvien was approved for DME in 2012 as its first indication; commercial availability of Iluvien is limited to Germany and the U.K., among the EU5 countries. How have these therapies been incorporated into the DME treatment algorithm in individual EU5 countries? What product attributes are most important to physicians when they select a specific DME therapy? How do physicians perceive each of these agents to perform across these product attributes, and how do perceptions compare with those of the treatment mainstay, Lucentis, the first therapy approved for DME, and off-label Avastin? What messaging efforts are Novartis, Bayer HealthCare, Allergan, and Alimera using to differentiate their products? How familiar are ophthalmologists with recent market events in the United States, such as the results from the Protocol T study and label expansion of Eylea and Lucentis to include treatment of DR in patients with DME?

  • Multiple therapies are in mid- to late-phase development for DME, including Optina, Luminate (ALG-1001), abicipar pegol, AKB-9778, and ASP-8232. How familiar are ophthalmologists with these products? How unique do physicians perceive these products to be compared with current therapies, and what are their biggest advantages and disadvantages? Do perceptions about these emerging therapies differ across the EU5 countries?


Markets covered: EU5 countries – France, Germany, Italy, Spain, United Kingdom.

Primary research: 227 retinal specialists and general ophthalmologists.

Indication coverage: diabetic retinopathy; diabetic macular edema.

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

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

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