Age-related macular degeneration (AMD) is a leading cause of visual impairment and blindness. More than half of advanced AMD patients suffer the wet (exudative, neovascular) form of the disease, characterized by abnormal growth of new blood vessels from under the retina that leak blood and fluid, often causing acute vision loss. Several currently available therapies targeting vascular endothelial growth factor (VEGF) have been shown to maintain and even improve visual acuity in wet AMD patients. The most frequently used anti-VEGF agents in wet AMD, administered via intravitreal (eye) injections, are Genentech’s cancer drug Avastin (bevacizumab), compounded for use in wet AMD; Genentech’s Lucentis (ranibizumab); and the most recent market entrant, Regeneron’s Eylea (aflibercept). Valeant/Pfizer’s Macugen (pegaptanib sodium) and QLT/Novartis’s Visudyne (verteporfin) in combination with photodynamic therapy are also used, though considerably less frequently, in wet AMD.
Using national, longitudinal, patient-level U.S. claims data, this report examines current trends in the management of wet AMD both for newly diagnosed patients and patients filling a prescription for a key therapy in Q3 2013. For the newly diagnosed patient sample, the report provides shares by line of therapy and a quantitative analysis of initiation and switching patterns between wet AMD agents. Analysis of the recently treated patient sample quantifies a drug’s source of business compared with its competitors and details which drugs precede others. Additional analyses explore how physicians’ decisions regarding brand dosing frequency impact traditional measures of persistence as well as compliance persistency and compliance by brand.