The age-related macular degeneration (AMD) market is expected to grow at a compound annual growth rate (CAGR) of 10.2% over the course of the forecast period (2024–34), reaching $20.5bn across the seven major markets (7MM) (US, France, Germany, Italy, Spain, UK, and Japan) according to GlobalData’s recent report ‘Age-Related Macular Degeneration: Seven-Market Drug Forecast and Market Analysis‘. Major driving factors of this growth include the launch of longer-acting anti-vascular endothelial growth factor (VEGF) therapies and tyrosine kinase inhibitor (TKI) therapies to treat patients with wet age-related macular degeneration (wAMD), the availability of therapies for geographic atrophy (GA), which will increase the number of treatable cases of AMD, and the launch of the first therapy exclusively for early AMD, which will increase treatment options available for patients with this sub-indication.
AMD is a condition where the macula, a small, oval-shaped area of the retina that is responsible for high-acuity and central vision, breaks down, giving rise to symptoms that include blurred vision, poor contrast sensitivity, metamorphopsia, visual hallucinations, and slow visual recovery after photostress tests. While AMD does not lead to complete blindness, the loss of central vision can negatively impact patients’ quality of life as everyday tasks become increasingly challenging. In interviews with GlobalData, key opinion leaders (KOLs) emphasised that the greatest unmet needs in the AMD space included the need for longer-acting therapies, treatment for GA, the prevention of fibrosis, and addressing the patient and healthcare system burden.
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Looking ahead, some of the current late-stage pipeline products for wAMD emulate what is currently on the market, employing the VEGF mechanism of action. This includes AbbVie and REGENXBIO’s RGX-314 (surabgene lomparvovec), Adverum Biotechnologies’ ADVM-022 (ixoberogene soroparvovec), and 4DMT’s 4D-150, among others. Therapies that are anticipated to reach the AMD market during the forecast will introduce new mechanisms of action in the wAMD space, including EyePoint Pharmaceuticals’ Duravyu (vorolanib), and Ocular Therapeutix’s Axpaxli (axitinib SR), both of which are TKIs; Asvattha Therapeutics’ D-4517, which is a platelet-derived growth factor receptor (PDGFR) inhibitor and VEGF inhibitor; and Merck’s MK-3000, which is a wnt agonist therapy, among others.
The late-stage pipeline for GA comprises 12 therapies across the 7MM. These include Annexon’s ANX-007, which is a complement C1q subcomponent inhibitor, Ocugen’s OCU-410, which is a nuclear receptor ROR alpha activator, and Lineage Cell Therapeutics’ OpRegen, which is a cell therapy comprising allogenic RPE stem cells, among others. While there are already two therapies on the market for GA in the US, and one conditionally approved therapy for GA in Japan, this will be of great benefit for patients in the EU, where there are no approved therapy options for GA. As for early AMD, Fabhalta, a complement factor B inhibitor, which is already marketed for IgA nephropathy (Berger’s disease), membranoproliferative glomerulonephritis type II (dense deposit disease or C3 glomerulopathy), or paroxysmal nocturnal haemoglobinuria, is set to launch across the 7MM within the forecast period. This is of great benefit within the AMD space across the 7MM, finally providing a treatment option for patients with early AMD.
Furthermore, the market is currently saturated with therapies that employ the intravitreal route of administration; nonetheless, there are some therapies currently in the pipeline for both wAMD and GA that employ alternative routes of administration. For wAMD, options include Ashvattha Therapeutics’ D-4517, which employs a subcutaneous route of administration, whereas for GA, options include Belite Bio’s LBS-008 and Alkeus Pharmaceuticals’ ALK-001, both of which are administered orally, and Veopoz and cemdisiran, both of which are administered subcutaneously. As these therapies can be self-administered, this will greatly reduce treatment burden, which is of paramount interest as most patients with AMD are older.
Simultaneously, therapies with longer treatment intervals are a dominant trend in the AMD pipeline. GlobalData forecasts that high-dose Eylea (aflibercept 8mg) will ensure that Eylea retains a large market share within the wAMD space throughout the forecast period, due to its potential shown in extending treatment intervals in clinical trials. Nonetheless, it will directly compete with Roche and Genentech’s Vabysmo (faricimab). Other examples of therapies that aim to provide longer treatment intervals include Adverum Biotechnologies’ ADVM-022, AbbVie and REGENXBIO’s RGX-314, 4DMT’s 4D-150, EyePoint Pharmaceuticals’ Duravyu, and Ocular Therapeutix’s axitinib SR, among others. As for GA, therapies that aim to provide longer treatment intervals include Ocugen’s OCU-410, Roche’s OpRegen, and Luxa Biotechnology’s RPESCRPE-4W, among others.
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By GlobalDataWhile the AMD market is projected to grow in the forecast period across the 7MM, it may face some challenges. Throughout the forecast period, therapies are expected to lose market exclusivity, leading to the anticipated entry of biosimilars. Nonetheless, the launch of late-stage pipeline therapies with new mechanisms of action, routes of administration, longer treatment intervals, and improved efficacies will undoubtedly be a driving force for market growth in the AMD space.
