Geographic atrophy (GA), an advanced form of dry age-related macular degeneration (AMD), is a leading cause of visual impairment and blindness in the United States and Europe. Degradation of cells in the retinal pigment epithelium under the retina and the related atrophy of macular photoreceptors are characteristic of GA. The primary goal of GA treatment is to stop or slow disease progression to prevent vision loss. With no approved therapies for GA, over-the-counter high-dose antioxidants and minerals (AREDS supplements) are often recommended to GA patients even though they have not been shown to be effective in reducing GA progression specifically. Thus, unmet need is high in this indication, leaving substantial commercial opportunity for novel GA therapies.

The Unmet Need content provides quantitative insight into U.S. and European physician perceptions of key treatment drivers and goals in the treatment of GA and the current level of unmet need associated with the disease. We analyze commercial opportunities in the GA market and discuss how emerging therapies may capitalize on these opportunities.

Questions Answered:

  • What are the treatment drivers and goals for GA?
  • What attributes are key influencers, which have limited impact, and which are hidden opportunities?
  • How do current therapies perform on key treatment drivers and goals for GA?
  • What are the prevailing areas of unmet need and opportunity in GA?
  • What trade-offs across different clinical attributes and price are acceptable to U.S. and European ophthalmologists for a hypothetical new GA drug?

Markets covered: United States, United Kingdom, France, Germany

Primary research: Survey of 60 U.S. and 32 European ophthalmologists fielded in January 2017

Key companies: Roche/Genentech, Ophthotech, Allergan, Janssen, Apellis Pharmaceuticals

Key drugs: Lampalizumab, Zimura, brimonidine tartrate intravitreal implant, CNTO-2476, APL-2

Table of contents

  • Dry And Wet Age-Related Macular Degeneration - Unmet Need - Detailed, Expanded Analysis: Geographic Atrophy
    • Key Updates
      • October 2017
        • July 2017
          • April 2017
          • Treatment Drivers and Goals
            • Overview
            • Rationale for Treatment Drivers and Goals Selection
              • Efficacy
              • Safety and Tolerability
              • Convenience of Administration
            • Physician Rating of Treatment Drivers and Goals in GA
              • Importance of Efficacy Attributes to Prescribing Decisions in GA: United States
              • Importance of Efficacy Attributes to Prescribing Decisions in GA: Europe
              • Importance of Safety and Tolerability Attributes to Prescribing Decisions in GA: United States
              • Importance of Safety and Tolerability Attributes to Prescribing Decisions in GA: Europe
              • Importance of Convenience of Administration Attributes to Prescribing Decisions in GA: United States
              • Importance of Convenience of Administration Attributes to Prescribing Decisions in GA: Europe
            • Stated vs. Derived Importance of Treatment Drivers and Goals
              • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in GA: United States
              • Stated vs. Derived Importance of Key Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Attributes to Prescribing Decisions in GA: Europe
          • Product Performance Against Treatment Drivers and Goals
            • Overview
            • Rationale for Drug Selection
              • Products for GA
            • Current Brand Performance on Key Treatment Drivers and Goals
              • Overall Performance of Key Therapies for GA: United States
              • Overall Performance of Key Therapies for GA: Europe
              • Relative Performance of Key Therapies for GA Across Select Efficacy Attributes: United States
              • Relative Performance of Key Therapies for GA Across Select Efficacy Attributes: Europe
              • Relative Performance of Key Therapies for GA Across Select Safety and Tolerability Attributes: United States
              • Relative Performance of Key Therapies for GA Across Select Safety and Tolerability Attributes: Europe
              • Relative Performance of Key Therapies for GA Across Select Convenience of Administration Attributes: United States
              • Relative Performance of Key Therapies for GA Across Select Convenience of Administration Attributes: Europe
          • Assessment of Unmet Need
            • Overview
            • Overall Satisfaction with Current Treatment
              • Surveyed Ophthalmologists’ Satisfaction with the Performance of Key Therapies for GA on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: United States
              • Surveyed Ophthalmologists’ Satisfaction with the Performance of Key Therapies for GA on Efficacy, Safety and Tolerability, Convenience of Administration, and Nonclinical Factors: Europe
            • Physician Rating of Unmet Need in GA
              • Surveyed Ophthalmologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in GA: United States
              • Surveyed Ophthalmologists' Ascribed Level of Unmet Need Across Key Efficacy Attributes in GA: Europe
              • Surveyed Ophthalmologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in GA: United States
              • Surveyed Ophthalmologists' Ascribed Level of Unmet Need Across Key Safety and Tolerability Attributes in GA: Europe
              • Surveyed Ophthalmologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in GA: United States
              • Surveyed Ophthalmologists' Ascribed Level of Unmet Need Across Key Convenience of Administration Attributes in GA: Europe
            • Unmet Need in GA and Related Indications
              • Surveyed Ophthalmologists' Ascribed Level of Unmet Need in GA and Related Indications: United States
              • Surveyed Ophthalmologists' Ascribed Level of Unmet Need in GA and Related Indications: Europe
          • Opportunity Analysis
            • Areas of Opportunity in the GA Market and Emerging Therapy Insights
              • Opportunity: A Therapy Offering Reduction in GA Area Progression in GA Patients
              • Opportunity: A Therapy Offering Reduction in Visual Acuity Decline in GA Patients
              • Opportunity: A Therapy Offering Reduction in Decline of Reading Speed in GA patients
              • Opportunity: A Therapy for GA with a Convenient Delivery Profile
          • Target Product Profiles
            • Assessing Drug Development Opportunities
            • Target Product Profile Methodology
              • Attributes and Attribute Levels
            • Attribute Importance and Part-Worth Utilities
              • GA Target Product Profile: Attribute Importance
              • Reduction in GA Area Progression from Baseline at Two Years Relative to Placebo
              • Mean Change from Baseline in BCVA at Two Years
              • Mean Change from Baseline in Mean Binocular Reading Speed at Two Years
              • Incidence of Serious Ocular AEs at Two Years
              • Incidence of Serious Non-Ocular AEs at Two Years
              • Delivery Profile
              • Price Per Year Relative to Lucentis (Assuming Six Injections Per Year)
            • Conjoint Analysis-Based Simulations of Market Scenarios
              • GA Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 1
              • GA Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 1
              • GA Market Simulations: Target Product Profiles Included in Scenario 1
              • GA Market Simulations: Share of Preference of Target Product Profiles Included in Scenario 2
              • GA Market Simulations: Likelihood to Prescribe Target Product Profiles Included in Scenario 2
              • GA Market Simulations: Target Product Profiles Included in Scenario 2
          • Appendix
            • Key Abbreviations
            • Experts Interviewed
            • Bibliography

        Author(s): Himanshu Jain, M.S. Pharm ; Emma McFadden, PhD

        Himanshu joined the CNS / ophthalmology team at Decision Resources Group in 2016. He has authored content for psychiatry and ophthalmology (retinal / nonretinal) indications, including schizophrenia, age-related macular degeneration, diabetic retinopathy / diabetic macular edema, dry eye disease, glaucoma, and uveitis.

        Himanshu has more than ten years of experience working in market research and consulting firms, and has managed multiple market assessment projects, including bottom-up forecasts, across multiple therapy areas. He holds a M.S. degree in Pharmacology and Toxicology from the National Institute of Pharmaceutical Education and Research in India and an Executive Post-Graduate Diploma in International Business from the Indian Institute of Foreign Trade.

        Emma McFadden, Ph.D., is a Director within the Central Nervous System/Ophthalmology disorders group. Her main focus is on ophthalmic indications, such as age-related macular degeneration, diabetic retinopathy, and diabetic macular edema, although she has authored research across a number of other indications, including multiple sclerosis and epilepsy. 

        Prior to joining Decision Resources Group, Emma earned a B.A. in neuroscience and a Ph.D. in biochemistry from Trinity College Dublin.

         


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