Anti-Vascular Endothelial Growth Factor (Anti-VEGF) Therapeutics Market By Drug Type (Monoclonal Antibodies, Recombinant Fusion Proteins, Small Molecule Inhibitors, Biosimilars); By Route of Administration (Intravitreal Injection, Intravenous Infusion, Oral); By Application (Ophthalmology [AMD, DME, RVO], Oncology [Colorectal Cancer, NSCLC, RCC, Others]); By End User (Hospitals, Specialty Clinics, ASCs, Research Institutes); By Geography, Segment Revenue Estimation, Forecast, 2026–2032

Anti-VEGF Therapeutics Market: Biosimilars Reprice the Injection Base as Durability Becomes the Premium Battleground

The Global Anti-Vascular Endothelial Growth Factor (Anti-VEGF) Therapeutics Market is estimated to reach USD 14.23 billion in 2025 and is projected to grow to USD 24.09 billion by 2032, expanding at a CAGR of 7.8% during the forecast period, according to Strategic Market Research.

 

The anti-vascular endothelial growth factor therapeutics market is a recurring-dose pharmaceutical market built around intravitreal retinal treatment and, to a lesser extent, systemic bevacizumab-based oncology regimens. Commercial demand is measured more accurately through administered doses, injection events, treated patient-years and infusion cycles than through conventional retail prescriptions. Medicare recorded approximately 3.44 million intravitreal injection services under CPT 67028 in 2021, up from fewer than 3,000 services in 2000. The increase occurred alongside lower utilization of retinal laser, cryotherapy and photodynamic therapy, reflecting the long-term transfer of treatment activity toward injectable medicines. CMS also requires the retinal drug code and intravitreal administration code to be submitted on the same claim, confirming that drug acquisition, reimbursement and repeat administration form one commercial pathway.

 

Public commercial evidence is concentrated in ophthalmology, where aflibercept, faricimab, ranibizumab, bevacizumab and their biosimilars serve wet age-related macular degeneration, diabetic macular edema, diabetic retinopathy and macular edema following retinal vein occlusion. Systemic bevacizumab remains relevant across several cancer settings, but that segment has matured into a hospital-contracting and biosimilar-volume business. Broad disease prevalence cannot be treated as anti-VEGF demand because treatment eligibility depends on disease subtype, active leakage or edema, visual and anatomical criteria, previous response, continued clinical benefit and the availability of alternative management.

 

Repeat Treatment, Not Diagnosis Alone, Creates the Revenue Pool

The U.S. disease funnel is large, although available surveillance categories extend beyond the population receiving anti-VEGF therapy. CDC estimated that 1.486 million Americans aged 40 and older had vision-threatening AMD in 2019. That definition combines exudative or wet AMD with geographic atrophy, so it overstates the anti-VEGF-addressable AMD population. CDC separately estimated that 1.838 million people had vision-threatening diabetic retinopathy in 2021, including severe non-proliferative disease, proliferative diabetic retinopathy and diabetic macular edema. Some of these patients are monitored, treated with laser or managed through systemic diabetic control rather than receiving repeated anti-VEGF injections.

England provides one of the more treatment-specific public estimates. NICE modeled approximately 269,000 people with wet AMD as eligible for faricimab by the fifth year of implementation, comprising about 232,000 prevalent and 37,000 incident eligible patients. NICE’s assumed 10% uptake among eligible incident patients represented a budget-impact scenario rather than observed adoption. The distinction matters commercially: prevalence describes clinical need, while treated volume is reduced by diagnosis rates, referral capacity, eligibility rules, patient acceptance, treatment discontinuation and reimbursement decisions.

The recurring nature of therapy gives the market a strong lifetime-value component. A newly treated retinal patient can generate multiple drug and administration claims during loading, maintenance and recurrence management. Revenue per patient nevertheless varies substantially by product price, dosing interval, bilateral disease, treatment response, switching and adherence. Longer labeled intervals may reduce injection frequency, but they do not eliminate monitoring visits or guarantee that every patient will reach the longest permitted interval.

 

Eylea’s 2025 Decline Reflects Competitive Reallocation Rather Than the Disappearance of Demand

Regeneron and Bayer’s Eylea franchise remained the largest publicly disclosed ophthalmic anti-VEGF business in 2025, generating approximately USD 7.891 billion globally. The franchise declined by about 17% from USD 9.545 billion in 2024. U.S. sales fell to USD 4.385 billion, a decrease of approximately 27%, as legacy Eylea 2 mg faced faricimab, aflibercept biosimilars, compounded bevacizumab and internal migration toward Eylea HD. Regeneron also identified patient affordability and copay pressure as contributors to switching toward lower-cost compounded bevacizumab.

The revenue decline did not affect every part of the franchise equally. Eylea HD generated USD 1.637 billion in U.S. sales during 2025 and represented approximately 37% of the company’s U.S. Eylea franchise. The rapid mix shift indicates that retina specialists and payers will continue to fund premium anti-VEGF products when durability, clinical familiarity and dosing flexibility provide a credible reason to remain within the franchise. It also exposes a cannibalization risk: part of Eylea HD’s growth replaces revenue previously generated by Eylea 2 mg rather than adding an entirely new patient population.

Regeneron expanded Eylea HD’s competitive position through additional dosing options. The FDA approved the product for macular edema following retinal vein occlusion and added a four-week dosing option in November 2025. In April 2026, the U.S. label was extended to allow intervals of up to 20 weeks after the first treatment year for selected responding patients with wet AMD or diabetic macular edema. These changes protect premium positioning by giving physicians greater control over difficult-to-treat and stable patients rather than competing directly with biosimilars on acquisition price.

 

Vabysmo Has Converted Durability into a Multi-Billion-Dollar Franchise

Roche’s Vabysmo generated approximately USD 3.4 billion in the company’s U.S. operations in 2025. More than eight million doses had been distributed globally by September 2025, demonstrating substantial physician experience across wet AMD, diabetic macular edema and retinal vein occlusion. The product’s commercial appeal rests on the possibility of extending treatment intervals while addressing both VEGF-A and angiopoietin-2, but its revenue performance is more important to the market than the mechanism alone. Vabysmo has given prescribers a premium alternative when existing aflibercept or ranibizumab treatment produces an incomplete response, frequent recurrence or an unacceptable visit burden.

Roche reported that Vabysmo’s growth rate slowed as the overall retinal market contracted, suggesting that premium innovation does not fully insulate a supplier from biosimilar conversion, patient affordability constraints or reduced injections per controlled patient. The same financial report showed U.S. Lucentis sales falling 58% to USD 69 million in 2025, largely because of competition and patient switching to Vabysmo. Roche has therefore shifted anti-VEGF value from a mature ranibizumab brand into a newer retinal franchise rather than protecting the legacy product through price competition.

 

Aflibercept Biosimilars Have Become a Revenue Segment, Not a Future Threat

The FDA approved Yesafili from Biocon Biologics and Opuviz from Samsung Bioepis as the first interchangeable biosimilars to Eylea in May 2024. Interchangeability supports payer and provider confidence, although ophthalmic anti-VEGF switching is not governed by retail-pharmacy substitution alone. These products are administered through physician offices and hospital outpatient departments, making formulary policy, practice acquisition cost, reimbursement spreads, contract terms, inventory management and physician switching protocols more influential than a conventional pharmacy substitution designation.

Amgen’s Pavblu demonstrates the speed at which an aflibercept biosimilar can convert approval into commercial volume. Pavblu generated USD 700 million in 2025 following its late-2024 launch and recorded USD 280 million during the first quarter of 2026. Amgen attributed the sequential first-quarter increase primarily to 16% volume growth, partly offset by inventory effects. These results confirm that biosimilar uptake can occur rapidly when a supplier combines competitive contracting, a dedicated reimbursement code, provider access and reliable supply.

Aflibercept biosimilars place the greatest pressure on legacy Eylea 2 mg rather than automatically displacing every branded retinal therapy. Eylea HD and Vabysmo retain differentiated dosing and evidence positions, while compounded bevacizumab remains the lowest-cost alternative in many U.S. practices. The market is separating into a price-sensitive volume tier and a premium durability tier, with fewer commercially defensible positions between them.

 

Public Payers Are Turning Clinical Similarity into Procurement Leverage

NHS England’s national retinal-medicines framework, implemented from December 1, 2025, recommends the lowest-cost clinically appropriate treatment. Aflibercept 2 mg biosimilars and ranibizumab biosimilars occupy the preferred value position for suitable patients, while more expensive products can be selected when clinical circumstances justify their use. Centralized procurement gives public systems leverage over net pricing and creates large-volume opportunities for suppliers that can meet tender requirements, maintain dependable supply and support local switching programs.

NHS analysis also limits exaggerated claims about treatment-burden reduction. Appointment requirements were broadly similar across diabetic macular edema options, although faricimab and aflibercept 8 mg were associated with slightly fewer appointments. The wet-AMD comparison did not identify a significant difference in injection numbers between treatments. A longer maximum label interval therefore needs to translate into fewer real-world injections, lower clinic workload or better persistence before it can support a durable price premium.

The U.S. pathway is more fragmented. Medicare and commercial insurers influence product selection through coverage policies, coding, step requirements and reimbursement, while retina practices also consider drug acquisition costs and payment timing under the buy-and-bill model. Patients may still face coinsurance or affordability barriers even when a product is covered. Premium suppliers must consequently align clinical evidence with payer access, patient assistance, coding support and practice economics.

 

Sustained Delivery Introduces a Device-Drug Revenue Model

Roche’s Susvimo creates a distinct anti-VEGF subsegment based on continuous ocular delivery rather than repeated conventional injections. The FDA approved Susvimo for diabetic macular edema in February 2025 with refills every six months and for diabetic retinopathy in May 2025 with refills every nine months. Eligible patients must previously have responded to intravitreal anti-VEGF treatment. The platform could retain patients within the ranibizumab franchise while reducing routine injection frequency for selected individuals.

Susvimo does not function as a simple injection substitute. It requires one-time surgical implantation, trained facilities, refill procedures and management of device-specific risks. Roche reintroduced the product in 2024 after a voluntary recall related to the implant and insertion tool. Adoption will therefore depend on whether reduced injection frequency compensates providers and patients for procedural complexity, surgical capacity and safety monitoring. The product also shifts part of the market from repeated drug acquisition toward a combined implant, refill and specialty-service pathway.

 

Oncology Remains Clinically Broad but Commercially Mature

Bevacizumab maintains a secondary anti-VEGF revenue pool across metastatic colorectal cancer, non-squamous non-small cell lung cancer, recurrent glioblastoma, renal-cell carcinoma, cervical cancer, ovarian and related cancers, and hepatocellular carcinoma in combination with atezolizumab. Treatment is delivered through hospital and outpatient infusion channels in recurring cycles, with utilization determined by tumor type, line of therapy, combination regimen, clinical status and payer coverage rather than by cancer incidence alone.

The branded oncology segment is exposed to sustained biosimilar erosion. Roche’s U.S. Avastin sales declined 13% to USD 390 million in 2025, while bevacizumab biosimilars have become established products in hospital formularies and group-purchasing contracts. Competition increasingly centers on tender price, supply continuity, portfolio contracting and institutional confidence rather than molecule-level differentiation. Ophthalmic compounded bevacizumab follows a different regulatory and purchasing route, but its lower price also affects branded retinal market share.

 

Regional Revenue Conditions Differ More Than Clinical Demand

The United States remains the most valuable publicly disclosed anti-VEGF market because of high retinal treatment volume, established Medicare medical-benefit reimbursement and continued adoption of premium brands. It is also commercially volatile. Biosimilar contracting, patient coinsurance, compounded bevacizumab, practice-level buy-and-bill economics and rapid switching can alter revenue faster than the underlying number of retinal patients.

European markets place greater weight on health-technology assessment, tendering and lowest-cost treatment policies. England’s biosimilar-first framework provides a clear example of how public buyers can redirect substantial recurring volume while reserving premium products for patients with a documented clinical rationale. Suppliers entering these systems need competitive net pricing and assured supply rather than relying solely on regulatory approval.

Bayer reported approximately EUR 3.11 billion in Eylea sales outside the United States in 2025, down 5.9% on a reported basis. The company cited lower prices and competitive pressure, particularly in Canada, the United Kingdom and Japan. Eylea 8 mg accounted for roughly 26% of overall Eylea sales, indicating that the migration toward premium higher-dose therapy is occurring beyond the U.S. market but is being moderated by national pricing and biosimilar policies.

 

Competitive Positions Are Dividing into Four Commercial Tiers

• Premium differentiated retinal therapies: Eylea HD and Vabysmo command the strongest branded positions through dosing flexibility, broad retinal indications, physician experience and accumulated clinical evidence. Their ability to preserve value will depend on real-world persistence and appointment reduction, not maximum label intervals alone.

• Biosimilar volume suppliers: Pavblu, Yesafili, Opuviz and ranibizumab biosimilars compete through payer preference, acquisition economics, contracting and supply reliability. Revenue can scale rapidly, but additional entrants may compress prices and reduce margins across the category.

• Mature and commoditized molecules: Legacy Lucentis, Eylea 2 mg in biosimilar-exposed markets and oncology Avastin face declining branded value. These molecules retain substantial clinical utilization, but a growing proportion of the revenue is moving to biosimilar manufacturers or lower-cost procurement channels.

• Sustained-delivery platforms: Susvimo offers a lower-frequency treatment model with a different provider workflow. Commercial success requires specialist training, service capacity, device reliability and evidence that patients remain controlled with fewer treatment encounters.

 

Anti-VEGF Market Outlook

Anti-VEGF demand remains structurally supported by chronic retinal disease, repeated treatment requirements and a large existing prescriber and reimbursement infrastructure. Revenue growth will not be distributed evenly across products. Biosimilars are positioned to capture injection volume and public-payer contracts, while premium brands must justify higher prices through durable disease control, flexible dosing, reliable supply and measurable reductions in treatment burden.

Regeneron and Roche are protecting value by migrating patients toward Eylea HD, Vabysmo and sustained delivery. Amgen, Biocon Biologics, Samsung Bioepis and other biosimilar suppliers are changing the economics of the established injection base. Public systems are using clinical similarity to negotiate lower costs, while U.S. payers and providers are balancing product price against reimbursement, patient affordability and practice economics.

The strongest commercial opportunities will belong to products that occupy a clear position rather than competing as undifferentiated anti-VEGF injections. Biosimilars need scale, contracting strength and dependable manufacturing. Premium therapies need evidence that longer intervals work outside controlled trials and reduce clinic workload without sacrificing vision outcomes. Sustained-delivery systems need to prove that lower injection frequency outweighs implantation complexity. Suppliers unable to establish one of these advantages will face shrinking branded volume, price compression and increasing payer control over product selection.

 

Anti Vascular Endothelial Growth Factor Therapeutics Market Report Coverage Table

Report Attribute	Details
Forecast Period	2026 – 2032
Market Size Value in 2025	USD 14.23 Billion
Revenue Forecast in 2032	USD 24.09 Billion
Overall Growth Rate	CAGR of 7.8% (2026 – 2032)
Base Year for Estimation	2025
Historical Data	2019 – 2024
Unit	USD Million, CAGR (2026 – 2032)
By Drug Type	Monoclonal Antibodies; Recombinant Fusion Proteins; Small Molecule Inhibitors; Biosimilars
By Route of Administration	Intravitreal Injection; Intravenous Infusion; Oral
By Application	Ophthalmology (AMD, DME, RVO); Oncology (Colorectal Cancer, NSCLC, RCC, Others)
By End User	Hospitals; Specialty Clinics; Ambulatory Surgical Centers (ASCs); Research Institutes
By Geography	North America; Europe; Asia-Pacific; Latin America; Middle East & Africa
Market Drivers – Growth in Retinal Disease Treatment Demand	Increasing prevalence of age-related macular degeneration, diabetic macular edema, retinal vein occlusion, and other retinal disorders is sustaining demand for recurring anti-VEGF therapies.
Market Drivers – Expansion of Biosimilar Competition	Increasing approvals and adoption of aflibercept and ranibizumab biosimilars are reshaping pricing structures and expanding access to anti-VEGF treatments.
Market Drivers – Shift Toward Durable Treatment Options	Development of longer-acting therapies and sustained-delivery platforms is creating premium opportunities by reducing injection frequency and treatment burden.
Customization Option	Available upon request