Market Access, Pricing and Reimbursement Landscape Assessment for Select Posterior Segment Ophthalmic Therapies

Landscape Assessment

Background & Objectives

  • Client wanted to understand investment opportunity in ophthalmology indications
  • Key issues to consider included:
    • Wide spectrum of possible disorders needed to be researched then scope focused
    • Clinical profile of client asset not available therefore multiple endpoints needed to be tested
    • Off-label usage of unlicensed therapies possible concern for new market entrants
    • Hands-off client meant scope needed to be broad but insight rich

Markets in Scope:
France, Germany, UK, Canada, Japan

Methods & Results

  • Secondary research to identify therapy area guidelines and current clinical/economic landscape
  • Primary research with Payers/KOLs to identify unmet needs across therapeutic areas and clinical/economic requirements for new therapies
  • Insights delivered include:
    • Cost is a major Payer concern in this disease space due to the use of anti-VEGF treatments
      • —Off-label use across indications is additional potential barrier to higher cost treatments
      • —Payers may seek to restrict expensive treatments to certain sub-groups to control budget impact
    • Payer education on the translation of anatomical clinical trial endpoints to harder functional and health-economic outcomes will be required

Implications: Provided the client with detailed overview of therapeutic area with focused insights that inform investment decisions as well as recommendations for clinical development for new market entrants

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