Biologic Competition, Payer Pressures, and Gene Therapy Momentum Define a Pivotal Moment in nAMD and DME Management, According to Spherix Global Insights
More than 70% of surveyed U.S. ophthalmologists anticipate a fundamentally transformed approach to managing nAMD and DME within the next five years.
Exton, Pennsylvania, July 10, 2025 (GLOBE NEWSWIRE) -- Recently released research from Spherix Global Insights provides a timely look at the increasingly competitive and complex treatment landscape for neovascular age-related macular degeneration (nAMD) and diabetic macular edema (DME). The Q2 wave of the syndicated RealTime Dynamix™ studies—based on responses from more than 100 U.S. ophthalmologists, primarily retina specialists—captures current prescribing dynamics, perceptions of leading therapies, and evolving expectations shaped by emerging treatments and payer influence.
Study findings reveal Roche/Genentech’s Vabysmo continues to command the lead in the retina market, earning strong marks for efficacy, physician satisfaction, and flexible dosing. Regeneron’s Eylea HD is steadily gaining ground as retina specialists sharpen their focus on newer, longer-acting options. At the same time, Eylea 2mg remains the preferred second line product, after Avastin, due to its long-term data, efficacy, and safety profile.
Despite high awareness, biosimilars remain on the periphery—particularly in the first-line setting. While many physicians are open to their use in principle, uptake remains modest, constrained in part by clinical conservatism and concerns about interchangeability. However, many ophthalmologists acknowledge that the payer environment could force a shift, especially if step therapy mandates begin to require biosimilar trials before branded biologic access.
Payer influence continues to cast a long shadow over treatment decisions, with roughly three-quarters of respondents reporting that coverage restrictions, prior authorization requirements, and cost-sharing concerns regularly impact prescribing choices. Physicians estimate that one in three patients with nAMD or DME are likely receiving less-than-optimal care due to these access-related hurdles. Most practices now rely on dedicated biologic coordinators to manage the administrative load, but even with support staff in place, prior authorizations remain a major friction point. The increasing use of AI-driven auto-denial systems is only exacerbating these delays, introducing new workflow inefficiencies, and stalling the initiation of preferred therapies.
Amid this increasingly complicated environment, gene therapies are offering a sense of future promise. Ophthalmologists are optimistic about the long-term potential of assets in development such as 4DMT’s 4D-150, AbbVie’s ABBV-RGX-314, and Adverum’s Ixo-vec. These agents are generating significant anticipation for their ability to reduce treatment burden and deliver transformative durability, potentially redefining the landscape beyond traditional biologics. Indeed, as the in-line competitive field tightens and new options on the horizon expand, over 70% of ophthalmologists expect a fundamentally reshaped treatment landscape within the next five years.
The latest Q2 update of the RealTime Dynamix™ series include responses from 112 U.S. ophthalmologists (101 for nAMD; 100 for DME) with high-volume patient caseloads. Data were collected between May 5 and June 11, 2025. As the market continues to shift under the pressure of payer dynamics and pipeline disruption, Spherix will continue to track these developments and deliver actionable insights to keep stakeholders ahead of the curve.
RealTime Dynamix™ is an independent service providing strategic guidance through quarterly or semiannual reports, which include market trending and a fresh infusion of event-driven and variable content with each wave. The reports provide an unbiased view of the competitive landscape within rapidly evolving specialty markets, fueled by robust HCP primary research and our in-house team of experts.
About Spherix Global Insights
Spherix is a leading independent market intelligence and advisory firm that delivers commercial value to the global life sciences industry, across the brand lifecycle.
The seasoned team of Spherix experts provides an unbiased and holistic view of the landscape within rapidly evolving specialty markets, including dermatology, gastroenterology, rheumatology, nephrology, neurology, ophthalmology, and hematology. Spherix clients stay ahead of the curve with the perspective of the extensive Spherix Physician Community.
As a trusted advisor and industry thought leader, Spherix’s unparalleled market insights and advisory services empower clients to make better decisions and unlock opportunities for growth.
To learn more about Spherix Global Insights, visit spherixglobalinsights.com or connect through LinkedIn.
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NOTICE: All company, brand or product names in this press release are trademarks of their respective holders. The findings and analysis addressed within are based on Spherix Global Insight’s analysis and do not imply a relationship with or endorsement of the companies or brands mentioned in this press release.
Bob Shewbrooks, Ophthalmology Franchise Head Spherix Global Insights 4848794284 bob.shewbrooks@spherixglobalinsights.com
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