{"id":292869,"date":"2026-07-17T00:00:00","date_gmt":"2026-07-17T00:00:00","guid":{"rendered":"https:\/\/clarivate.com\/life-sciences-healthcare\/report\/acreop0001-2024-biopharma-dry-and-wet-age-related-macular-degeneration-access-reimbursement-access\/"},"modified":"2026-07-18T11:20:32","modified_gmt":"2026-07-18T11:20:32","slug":"acreop0001-2026-biopharma-dry-and-wet-age-related-macular-degeneration-access-reimbursement-access-reimbursement-age","status":"publish","type":"report","link":"https:\/\/clarivate.com\/life-sciences-healthcare\/report\/acreop0001-2026-biopharma-dry-and-wet-age-related-macular-degeneration-access-reimbursement-access-reimbursement-age\/","title":{"rendered":"Dry and Wet Age-Related Macular Degeneration &#8211; Access &#038; Reimbursement &#8211; Access &#038; Reimbursement &#8211; Age-Related Macular Degeneration (US)"},"content":{"rendered":"<p>The U.S. wet <abbr title=\"age-related macular degeneration\">AMD<\/abbr> market is led by intravitreal therapies such as Eylea, Eylea <abbr title=\"high-dose\">HD<\/abbr>, and Vabysmo, alongside the continued off-label use of compounded Avastin, driven by cost considerations. In addition, the launch of Pavblu, a biosimilar of Eylea, adds further competitive pressure to established brands. Payer utilization management strategies remain key influencers of prescribing. The anticipated launch of <abbr title=\"tyrosine kinase inhibitor\">TKI<\/abbr>s (e.g., EyePoint\u2019s Duravyu, Ocular Therapeutix\u2019s Axpaxli) and particularly gene therapies (i.e., AbbVie \/ Regenxbio\u2019s sura-vec, Adverum \/ Eli Lilly\u2019s ixo-vec, and 4DMT\u2019s 4D-150), which aim to reduce dosing frequency compared with current options, raises questions about coverage and affordability. In parallel, the geographic atrophy (<abbr title=\"geographic atrophy\">GA<\/abbr>) market is evolving following the introduction of Apellis \/ Biogen\u2019s Syfovre and Astellas\u2019s Izervay in 2023. Understanding how <abbr title=\"managed care organization\">MCO<\/abbr>s approach formulary placement and access for both wet <abbr title=\"age-related macular degeneration\">AMD<\/abbr> and <abbr title=\"geographic atrophy\">GA<\/abbr> treatments will be critical for stakeholders navigating this competitive market.<\/p>\n<p><strong>QUESTIONS ANSWERED<\/strong><\/p>\n<ul class=\"BulletListStyle1 SCXP199306607 BCX0 round-bullets\">\n<li>How do payer policies and formulary restrictions affect access to <abbr title=\"age-related macular degeneration\">AMD<\/abbr> therapies in the United States?<\/li>\n<li>What cost-control measures are most commonly applied to branded <abbr title=\"age-related macular degeneration\">AMD<\/abbr> treatments?<\/li>\n<li>How does the availability of biosimilars influence coverage and reimbursement for reference brands?<\/li>\n<li>What are payers\u2019 perspectives on high-cost emerging therapies?<\/li>\n<li>How do access dynamics affect ophthalmologists\u2019 prescribing decisions across patient segments?<\/li>\n<\/ul>\n<p><strong>CONTENT HIGHLIGHTS<\/strong><\/p>\n<p><strong>Geography:<\/strong> United States<\/p>\n<p><strong>Primary research:<\/strong> Survey of 100 U.S. ophthalmologists; survey of 30 U.S. <abbr title=\"managed care organization\">MCO <\/abbr><abbr title=\"pharmacy director\">PD<\/abbr>s \/ <abbr title=\"medical director\">MD<\/abbr>s, and two interviews of <abbr title=\"medical director\">MD<\/abbr>s at national <abbr title=\"managed care organization\">MCO<\/abbr>s.<\/p>\n<p><strong>Fingertip formulary: <\/strong>Formulary coverage and restrictions data for wet <abbr title=\"age-related macular degeneration\">AMD<\/abbr> and <abbr title=\"geographic atrophy\">GA<\/abbr> therapies by plans covering approximately 20.4 million lives in U.S. commercial plans sponsored by <abbr title=\"managed care organization\">MCO<\/abbr>s.<\/p>\n<p><strong>Key drugs covered: <\/strong>Avastin, Eylea, Pavblu, Lucentis, Byooviz, Cimerli, Nufymco, Beovu, Susvimo<b>, <\/b>Vabysmo, Eylea <span class=\"abbreviation-guard\">HD<\/span>, sura-vec (ABBV-RGX-314), Ixo-vec, Duravyu, Axpaxli, Syfovre, and Izervay.<\/p>\n<p><strong>Content highlights:<\/strong><\/p>\n<p>Reimbursement and contracting.<\/p>\n<p>Access and prescribing.<\/p>\n<p>Opportunities and challenges for emerging therapies.<\/p>\n<p>Disease-specific special topic: treatment for geographic atrophy.<\/p>\n<p><strong>PRODUCT DESCRIPTION<\/strong><\/p>\n<p><em>U.S. Access &#038; Reimbursement <\/em>provides integrated brand- and disease-level insight on reimbursement dynamics and the impact of U.S. payer policy on physician prescribing behavior in the market access environment, including up-to-date analysis of drug coverage and restriction policies and payer and prescriber perspectives on key marketed drugs and receptivity to emerging therapies.<\/p>\n","protected":false},"template":"","class_list":["post-292869","report","type-report","status-publish","hentry","report-gateway-biopharma","biopharma-therapy-areas-age-related-macular-degeneration","biopharma-therapy-areas-ophthalmology","biopharma-geography-us","biopharma-date-2609"],"acf":[],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/report\/292869","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/report"}],"about":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/types\/report"}],"wp:attachment":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/media?parent=292869"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}