Diabetic Macular Edema / Diabetic Retinopathy – Special Topics – Special Topics: Biosimilar Anti-VEGF Agents (US)

The development of biosimilar versions of Lucentis and Eylea is of high interest in the ophthalmology market given the high cost of these agents, the large patient population suffering from retinal vascular diseases, and the need for frequent (and chronic) administration of these VEGF inhibitors to maintain/improve visual acuity. Biosimilars of ranibizumab 0.5 mg are in late-phase development and are expected to launch in the United States in 2021; Eylea’s patents are not expected to expire in the United States until 2023, so biosimilar development of aflibercept slightly lags that of ranibizumab. Avastin may not face the same threat from biosimilars in ophthalmologic indications because it is typically compounded and is already low cost. Regardless, marketers of current anti-VEGF agents and developers of emerging therapies will need to understand the potential patient-share impact of biosimilars to diversify and respond to revenue losses.


  • What factors most influence ophthalmologists’ choice of current anti-VEGF brands for wet AMD and DME? How familiar are ophthalmologists with biosimilar anti-VEGF therapies in development, and what are the sources of their familiarity? Do ophthalmologists have any concerns about the clinical characteristics of biosimilar anti-VEGF therapies?
  • How will ophthalmologists use biosimilar anti-VEGF therapies in their practice for wet AMD and DME? How do ophthalmologists feel about indication extrapolation of biosimilar anti-VEGF therapies? What portion of treatment-naive wet AMD and DME patients do ophthalmologists expect will be administered biosimilar anti-VEGF therapies instead of branded products?
  • How will the availability of biosimilar anti-VEGF therapies affect the patient share of emerging products, such as Novartis’s brolucizumab and Allergan’s abicipar pegol?
  • Do ophthalmologists expect anti-VEGF biosimilar treatment patterns to vary by indication? How do they expect the availability of off-label Avastin to affect their use of biosimilar anti-VEGF agents?


Geographies: United States

Primary research: Survey of 100 U.S. ophthalmologists, 84 of whom completed a retinal fellowship lasting at least 12 months

Key drugs covered: Avastin (Roche), Lucentis 0.3 mg and 0.5 mg (Roche), Eylea (Regeneron), FYB-201 (Bioeq/Formycon), SB-11 (Samsung Bioepis), Xlucane (Xbrane Biopharma/STADA Arzneimittel), MYL-1701P/M-710 (Mylan/Momenta Pharmaceuticals), Brolucizumab (Novartis), abicipar pegol (Allergan), faricimab (Roche), Conbercept (Chengdu Kanghong Biotech), Lucentis port-delivery system (PDS) (Roche)

Key insights provided: Physician-reported anti-VEGF treatment practices for wet AMD and DME, factors influencing choice of branded anti-VEGF agents, expected use patterns for emerging biosimilars of anti-VEGF agents in wet AMD and DME, expected impact of biosimilar anti-VEGF agents on the use of current and emerging therapies


Special Topics uses quantitative primary research to assess evolving trends and market effects in dynamic disease areas. The report examines topics of high interest to an indication, such as delving into reasons driving physicians’ prescribing decisions or assessing physicians’ receptivity to emerging agents in order to better understand the nuanced dynamics in the indication.

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