A Shifting Market

Driven by an aging population, treatments for conditions such as glaucoma and retinal diseases will continue to draw impressive revenues. However, as new technologies emerge and the healthcare system continues to cope with increasing economic pressures, demand for and adoption of certain treatments is likely to shift.

Glaucoma. For the most part, glaucoma continues to be a medically managed disorder, but innovators in the field have begun to demonstrate some long-term device-oriented alternatives to a lifetime of medical therapy. As pharmaceuticals that treat glaucoma now account for more than 40% of ophthalmic drug revenues, the need for a cost-effective solution has gained the attention of some entrepreneurial ventures, as well as payer and provider organizations. With the annual cost of medical management of a case of glaucoma reaching beyond $2000 per year, the potential adoption of a single, cost-effective surgical intervention that could replace a lifetime of costly medical management is not only justifiable, it is fiscally responsible.

The question remains, of course, as to whether any of the emerging device-oriented treatments can offer long-term relief of the intraocular pressure that contributes to the progression of this disease.

Back of Eye. Retinal diseases such as macular degeneration and retinal detachment are tied to the aging demographic and will continue to build momentum as the population ages. New pharmaceutical products have demonstrated promise in the treatment of patients with wet AMD, while treatment options for patients with dry AMD remain elusive. And as several new therapies have made a difference for patients with wet AMD, the cost of these therapies is of great consequence to U.S. and international markets alike. Because the cost of such therapies is so great, market penetration will be slow, creating an opportunity for new advances—many of which are at the investigational stages.

As acceptance for drug therapies that treat retinal disorders grows, these products will constitute a growing portion of the ophthalmic pharmaceutical sector, challenging glaucoma drugs as the largest burden to payers among ophthalmic drugs. On an annual basis, the cost of pharmaceuticals to treat retinal diseases outweighs the costs to treat glaucoma by a factor of 10 or more. And with the prevalence of back-of-eye diseases exceeding glaucoma by a multiple of five or more, in most countries it is easy to see that the financials associated with treating back-of-eye diseases are as daunting as the demand for these therapies is strong.

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