Wet age-related macular degeneration (wet AMD) is a progressive eye disease in which abnormal, fragile blood vessels grow under the macula and leak fluid or blood, leading to irreversible central vision loss if not treated. In many patients, untreated wet AMD can progress to legal blindness within months to a few years.
Wet AMD primarily affects older adults, with prevalence rising steeply with age. Recent analyses suggest that approximately 1–3% of individuals aged 75 years and older are affected, with hundreds of thousands of patients living with wet AMD in the US alone and substantial numbers of new diagnoses each year (1-3). As populations age, the overall burden of wet AMD is expected to increase further over the coming decades.
The current standard of care for wet AMD is based on intravitreal anti-VEGF therapies. These often require 6–10 injections in the first year, followed by ongoing injections in subsequent years, resulting in a long-term treatment burden for patients. Beyond the risk of complications from frequent injections, this regimen places significant pressure on healthcare services and on patients with their caregivers who must attend regular, time-consuming clinic visits. Despite intensive treatment, an estimated 25–35% of patients with more aggressive disease have partial or inadequate responses and remain at risk of progressive, irreversible vision loss.
Given these limitations, there is a strong unmet need for more durable, disease-modifying therapies. A broad R&D pipeline is investigating new molecular targets and innovative delivery technologies, including gene therapies designed to drive long-term intraocular expression of anti-VEGF or VEGF-targeting molecules. Gene therapies could thereby reduce or eliminate the need for repeated injections. Later-stage (pivotal Phase 3) AAV-based gene therapy candidates include 4D-150 (4D Molecular Therapeutics), ABBV-RGX-314 (sura-vec, Regenxbio/AbbVie) and ADVM-022 (ixo-vec, Adverum). These candidates have demonstrated meaningful reductions in annualized anti-VEGF injection burden in both treatment-naïve and heavily pre-treated populations. If successful in Phase 3 and regulatory review, they could start reaching major markets from around 2028 onwards.
Our new MarketVIEW analysis suggests that the commercial potential of gene therapies for wet AMD could be transformative. We estimate that the market opportunity for gene therapy could ultimately exceed the current global anti‑VEGF market for wet AMD, which is currently estimated at approximately $10 billion (industry figures). This projection is based on a treated population of approximately 60,000 global patients in 2033, under central forecast assumptions. However, overall market potential is highly sensitive to pricing methodology, depending on the approach taken to value cost offsets and long-term clinical benefit. Modelled gene therapy prices (*global averages) in our scenarios range from approximately $60,000 per patient in the low‑price case up to around $350,000 per patient in the gene‑therapy‑analogue case. In any case, the possibility of substantially reducing anti‑VEGF injections for wet AMD is likely to significantly impact revenues from currently approved anti‑VEGF products.
This MarketVIEW product is a brand-new commercial opportunity assessment focused on the potential of emerging gene therapies for wet AMD through to 2040, across 10 major high-income developed markets*. It delivers a patient-based, interactive forecast model (.xls) and a comprehensive Executive presentation (~165 slides). All methodology and key assumptions are clearly documented, and the analysis incorporates four pricing case studies centred on the potential healthcare costs averted by gene therapy versus the current standard of care. The product also includes an up-to-date review of disease background, epidemiology, the current anti-VEGF market and the evolving R&D landscape.
This analysis is ideally suited to organisations seeking a detailed, forward-looking global forecast for this emerging therapeutic class, including pharmaceutical and biotech companies, investors, and other stakeholders evaluating the strategic and commercial potential of gene therapies in wet AMD.
PRODUCT LINK: https://www.vaczine-analytics.com/products-marketviewVAMVG_wetAMD_gene_therapies.asp
- Saundankar, V., et al. (2025). Annual prevalence of geographic atrophy and wet age-related macular degeneration among Medicare Advantage enrollees in a US health plan. Journal of Managed Care & Specialty Pharmacy, 31(1), 88–98.
- Ehrlich, J. R., et al. (2023). Trends in the diagnosed prevalence and incidence of age-related eye diseases among Medicare fee-for-service beneficiaries, 2014–2019. JAMA Ophthalmology, 141(2), 123–132.
- Friedman, D. S., O’Colmain, B. J., Muñoz, B., Tomany, S. C., McCarty, C., de Jong, P. T. V. M., Nemesure, B., Mitchell, P., & Kempen, J. (2004). Prevalence of age-related macular degeneration in the United States. Archives of Ophthalmology, 122(4), 564–572.
*US, Canada, UK, France, Germany, Italy, Spain, Japan, Australia and South Korea
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