{"id":390842,"date":"2017-11-22T00:00:00","date_gmt":"2017-11-22T00:00:00","guid":{"rendered":"https:\/\/clarivate.com\/life-sciences-healthcare\/report\/acreop0001-2017-biopharma-age-related-macular-degeneration-access-and-reimbursement-us-2017\/"},"modified":"2026-03-31T10:49:32","modified_gmt":"2026-03-31T10:49:32","slug":"acreop0001-2017-biopharma-age-related-macular-degeneration-access-and-reimbursement-us-2017","status":"publish","type":"report","link":"https:\/\/clarivate.com\/life-sciences-healthcare\/report\/acreop0001-2017-biopharma-age-related-macular-degeneration-access-and-reimbursement-us-2017\/","title":{"rendered":"Age-Related Macular Degeneration | Access and Reimbursement | US | 2017"},"content":{"rendered":"<p>The wet age-related macular degeneration (AMD) market in the United States is unique given that the key approved therapies\u2014Roche \/ Genentech\u2019s Lucentis, Regeneron\u2019s Eylea, and Novartis\u2019s Beovu\u2014face competition from low-priced off-label Avastin (Roche \/ Genentech). The approved premium-priced therapies place a substantial burden on payers; therefore, despite being effective and safe, they are subject to payer restrictions. Competition is expected to increase with the launches of Roche\u2019s faricimab, Roche\u2019s ranibizumab port delivery system, Regeneron\u2019s high-dose aflibercept, Kodiak Sciences\u2019 KSI-301, and Regenxbio\u2019s RGX-314; these agents potentially offer a dosing advantage over the currently available VEGF inhibitors and address a substantial unmet in this market. Biosimilar versions of Eylea and Lucentis are also anticipated to launch soon, making it essential to understand how these therapies could impact access to premium-priced brands.<\/p>\n<p><strong>QUESTIONS ANSWERED<\/strong><\/p>\n<ul>\n<li>Does coverage of the key VEGF inhibitors for wet AMD differ on MCOs\u2019 largest Medicare Advantage and commercial insurance plans?<\/li>\n<li>How do various cost-control measures impact prescribing of approved wet AMD therapies Eylea, Lucentis, Beovu, and off-label Avastin? How are biosimilar versions of bevacizumab (Amgen\u2019s Mvasi and Pfizer\u2019s Zirabev) reimbursed or prescribed for wet AMD, if at all?<\/li>\n<li>Do ophthalmologists expect to prescribe late-phase emerging therapies to their Medicare and commercially insured wet AMD patients? How do payers expect to cover these therapies on their commercial and Medicare Advantage plans?<\/li>\n<li>How is the expected availability of biosimilars to Eylea and Lucentis likely to impact access to and reimbursement of their reference brands?<\/li>\n<\/ul>\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. managed care organization (MCO) pharmacy and medical directors (PDs \/ MDs)<\/p>\n<p><strong>KEY DRUGS COVERED:<\/strong> Avastin, Eylea, Lucentis, Beovu, faricimab, ranibizumab port delivery system, high-dose aflibercept, KSI-301, RGX-314<\/p>\n<p><strong>CONTENT HIGHLIGHTS: <\/strong>Reimbursement and contracting, access and prescribing, opportunities and challenges for emerging therapies, potential coverage and use of biosimilar anti-VEGF products<\/p>\n<p><strong>PRODUCT DESCRIPTION<\/strong><\/p>\n<p>U.S. Access &#038; Reimbursement 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-390842","report","type-report","status-publish","hentry","report-gateway-biopharma","biopharma-therapy-areas-age-related-macular-degeneration","biopharma-geography-us","biopharma-date-890"],"acf":[],"publishpress_future_workflow_manual_trigger":{"enabledWorkflows":[]},"_links":{"self":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/report\/390842","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"}],"version-history":[{"count":2,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/report\/390842\/revisions"}],"predecessor-version":[{"id":576792,"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/report\/390842\/revisions\/576792"}],"wp:attachment":[{"href":"https:\/\/clarivate.com\/life-sciences-healthcare\/wp-json\/wp\/v2\/media?parent=390842"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}