Roche held an Ophthalmology-focused investor event today at the end of the annual American Society of Retina Specialists Meeting in Stockholm, and provided some interesting insights on Vabysmo’s performance vs. Eylea:

The dynamic between Eylea and Vabysmo is notable to watch, for several reasons:

Both drugs are blockbusters of great importance to their respective companies - Eylea vaulted Regeneron into the league of premier biopharma companies, while Vabysmo has been a crucial growth driver for Roche as it faces LOEs on other key medicines like Actemra.

Second, both are part of a large and growing market - as life expectancy increases along with higher prevalence of risk factors like diabetes, Roche forecasts the size of the global retina-focused medicines market to rise from $15B last year to $17.5B by 2028.

During its event, Roche highlighted promising data for Vabysmo on several dimensions, most notably that over 90% of patients had achieved absence of Diabetic Macular Edema by the end of the 4 year RHONE-X study, compared to 81.7% of patients on Eylea.

Roche also presented data showing longer windows between treatment with Vabysmo compared to Eylea - between 8 and 16 days depending on what part of the data one considers.

Given how unpleasant it is for patients to get an injection into their eye, increased length between treatments is especially beneficial.

That is made all the more important because real-world practice and results in these indications often differs markedly from clinical trials given lower patient adherence.

Roche attributed those benefits in part to Vabysmo’s differentiated MOA - which inhibits both Ang-2 and VEGF, compared to just the latter for Eylea.

However, Regeneron is certainly not sitting still.

Since launching Eylea HD in August last year, its sales have increased rapidly, achieving $200M in Q1 ‘24, its only second full quarter on the market. Eylea HD also received a permanent J code in April, which will make billing and reimbursement more streamlined.

On Roche’s Q1 ‘24 conference call, analysts asked several questions of Vabysmo, which was mentioned 36 times in that single call.

In terms of market share, Vabysmo is clearly putting pressure on Eylea, which still remains the market leader: Regeneron reported in its Q1 earnings that Eylea and Eylea HD together accounted for 45% of the anti-VEGF category, down from 49% as of Q4 ‘23.

Given the attention both companies are putting into the roll out commercialization of these medicines, the results in the coming months will be an interesting case study.

PS: You can get the spreadsheet with the quarterly sales numbers by signing up (for free) on our open beta at mavenbio.io

Sales by quarter: (all sales in US Dollars)

Vabysmo:
Q3 2022 179 million

Q4 2022 321 million

Q1 2023 467 million

Q2 2023 584 million

Q3 2023 743 million

Q4 2023 840 million

Q1 2024 968 million

Eylea
Q3 2022 2.446 billion

Q4 2022 2.335 billion

Q1 2023 2.281 billion

Q2 2023 2.386 billion

Q3 2023 2.320 billion

Q4 2023 2.227 billion

Q1 2024 2.051 billion

Eylea HD:

Q3 2023: 43 million

Q4 2023: 123 million

Q1 2024: 200 million