New approvals for AMD

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So, it's actually a really exciting time in the retina space. We've had a number of new approvals that have come through. In the most recent year alone, we've looked at aflibercept, EYLEA HD, the eight milligram version that's been approved for several indications, but I think more importantly are some of the treatments that are now for diseases that previously had none. So the dry macular degeneration treatments, specifically avacincaptad pegol, which is Izervay, and pegcetacoplan, which is SYFOVRE. These are both treatments that target geographic atrophy in a way that tries to slow the progression. So, kind of finally offering some hope for patients in a disease that otherwise tended to have really poor outcomes for those patients that develop geographic atrophy. And then finally, just in terms of kind of logistics of delivering care, biosimilars have really started to take shape. We have two that exist now for ranibizumab, ranibizumab-nuna and EQRN. These are BYOOVIZ and CIMERLI, respectively. And so these are basically ways of delivering kind of the care we've had in the past, with new formulations essentially through these biosimilars. What's exciting about the biosimilar space is many more to come, potentially 16 new biosimilars for aflibercept coming in the future. So, more to come here. Yeah, so there's been a number of other treatment updates that have happened in this space. So for instance, faricimab, which is a medication VABYSMO, which got approval a little while back, has a new indication, which is for retinal vein occlusion.

So another tool in our toolkit, which we're excited about. And then really looking at alternative treatment approaches. And so, we've come up with a number of medicines that work well to treat patients, but the burden of kind of doing the repeated treatments becomes the barrier. And so port delivery devices have been developed that basically act like reservoirs that are surgically implanted, about the size of a grain of rice, and it's something that you can refill. So think of it as holding six months of medication, and it slowly releases, and so you fill it up every six months rather than getting treatments every month. So, different novel ways of delivering the medication is an exciting update as well. In terms of, there's also back office updates. So coding, on the coding end of the spectrum. These are perhaps less exciting but more important in terms of how we actually deliver the care to patients. And so for one, triamcinolone acetonide, which is XIPERE, as a suprachoroidal injection that recently got a new CPT code. That's 67516, and that was effective as of January 1st this year. For pegcetacoplan, they received a J code, J2781. That was as of October 1st of last year. And finally in the biosimilar space, Q codes that became available, Q5128 for CIMERLI, and Q5124 for BYOOVIZ. All of these codes basically just make it easier for us to access care and make it more reliable from an office perspective to ensure reimbursement so there's no surprises for you or the patient.