| Study Period | 2021 - 2032 |
| Market Size in 2025 | USD 3.8 Billion |
| Market Size in 2026 | USD 3.9 Billion |
| Market Size by 2032 | USD 5.2 Billion |
| Projected CAGR | 4.7% |
| Largest Country | Saudi Arabia |
| Fastest-Growing Country | Saudi Arabia |
| Market Structure | Fragmented |
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The wet age-related macular degeneration (AMD) market size was USD 10.6 billion for 2025, and it will grow by 6.7% during 2026–2032, to reach USD 16.7 billion by 2032.
The market growth is driven by the growing demand for anti-vascular endothelial growth factor (anti-VEGF) treatments, including aflibercept, ranibizumab, and faricimab, into intravitreal administration protocols. This makes these biologic treatments essential treatments to help preserve vision in patients suffering from neovascular age-related macular degeneration.
Published projections in Lancet Global Health show an estimated 288 million people worldwide will experience some form of age-related macular degeneration by 2040. Wet AMD accounts for 10–15% of those experiencing age-related macular degeneration; however, it has a disproportionate amount of severe visual impairment.
Additionally, the growing aging population demographics in North America, Europe and Asia-Pacific are creating increasing demand for wet AMD therapeutics. Anti-VEGF agents have greatly changed how clinicians manage wet AMD since FDA approvals began in 2006, demonstrating the ability to either maintain or improve vision in clinical populations when used in accordance with established treatment protocols.
The launch of biosimilars for wet AMD treatment is creating a new economic dynamic that is transforming the affordability of existing treatments through downward pressure on prices of branded biologic products and increasing the number of patients who can access these products as payers expand their coverage of these products, without a decrease in clinical effectiveness. In September 2021, the U.S. FDA approved the first ranibizumab biosimilar for the treatment of wet AMD, followed by subsequent approvals of aflibercept biosimilars in later years, including Yesafili and Opuviz in 2024.
According to Medicare Part B expenditure data, U.S. annual expenditures on anti-vascular endothelial growth factor (anti-VEGF) therapies exceed USD 4 billion. Despite the existence of a lower-cost alternative (bevacizumab), it is clear that the majority of this spending is on aflibercept and ranibizumab; therefore, biosimilar substitution offers significant opportunity for cost reduction, without loss of clinical benefit. In addition, increased competition between multiple biosimilar manufacturers for established anti-VEGF products will continue to drive price compression beyond initial launch discounts, consistent with price reductions greater than 50% seen in European markets following years of sustained biosimilar competition.
Increased access to Wet Age-related Macular Degeneration (Wet AMD) treatments via health insurance expansion is accelerating treatment use; this includes a growing number of emerging economies that have established national health insurance programs and are increasing coverage under private health insurance programs. The increase in access to Wet AMD treatments is due to decreased patient burden as the financial risks of treatment have been reduced in many countries.
Medicare Part B has provided full payment for the intravitreal injection of anti-VEGF drugs to treat Wet AMD in patients who qualify for the program, with the qualifying patients paying only 20% of the Medicare-approved cost for these treatments. This level of payment for intravitreal anti-VEGF drug delivery has enabled millions of Americans aged 65 years and older to access Wet AMD treatment, while also creating multi-billion-dollar annual Medicare program expenditures as a result of the high prevalence and need for long-term treatment of Wet AMD.
According to PubMed Central, Medicare spending on anti-VEGF eye injections increased from approximately USD 2.51 billion in 2014 to an estimated USD 4.02 billion in 2019. As of late, additional secondary analyses show that Medicare Part B continued to expend approximately USD 4.1 billion for ranibizumab and aflibercept in 2020 due to an increase in the use of high-cost drugs as well as an increase in the number of injections administered. The major factors contributing to this increase are the higher volumes of anti-VEGF treatments administered to an aging Medicare population and a higher average cost per unit of aflibercept, as compared to other lower-priced anti-VEGF products.
European national health services, such as those in Germany, France and the U.K., provide similar frameworks for coverage of anti-VEGF therapies as part of their treatment formularies. However, each country conducts its own health technology assessments, resulting in varying levels of coverage and negotiated prices for new agents prior to approval for use within their respective national health systems.
The Eylea category holds the largest market share, of 60%, in 2025, and it has the highest CAGR, of 6.8%. This is due to its well-established efficacy as demonstrated in pivotal clinical trials; broad reimbursement for aflibercept from national health care programs and private insurers; and the extensive long-term clinical use history of aflibercept dating back over a decade since the approval of aflibercept for treatment of wet AMD by the FDA in 2011.
The significant market share advantage of aflibercept is likely due to its pharmacokinetic advantages that allow bimonthly injections following an initial one-month loading phase of once-monthly injections, which results in less treatment burden than monthly ranibizumab injection therapy with equivalent protection of visual acuity based on long-term follow-up data. In 2024, the U.S. FDA approved Yesafili as the first interchangeable aflibercept biosimilar, as interchangeable means it can be substituted without physician consent of Eylea (aflibercept). Other aflibercept biosimilars have been approved, offering alternative treatments to the reference product, while still being therapeutically equivalent to the original.
The products analyzed in this report are:
The hospital pharmacy category holds the largest market share, of 70%, in 2025, due to the necessity for hospitals to administer intravitreal injections safely using sterile equipment, trained medical personnel, and dedicated ophthalmology settings. This is due to the requirement for precise vitreous access via slit-lamp biomicroscopy; the need for immediate post-injection monitoring for potential elevation of intraocular pressure (IOP) and other adverse events; and the ability to provide diagnostic imaging, treatment planning, and coordinated specialty care within a single healthcare facility. According to data from the IRIS Registry, the majority of intravitreal anti-VEGF injections are performed in hospital-based or clinic settings, reflecting real-world practice patterns across the United States.
The specialty pharmacy category is expected to register the highest CAGR, of 6.9%, driven by the growing number of biosimilars entering the market, which require specialty pharmacy cold-chain infrastructure to maintain 2–8 °C storage conditions for biological injectables; patient education programs supporting medication adherence; and prior authorization processes managed by specialty pharmacy clinical teams to facilitate payer approval and patient access to financial assistance programs.
The distribution channels analyzed in this report are:
The above 80 years category holds the largest market share, of 50%, in 2025. This represents an exponentially greater proportion of patients due to the natural progression of aging on retinas and the fact that this age group has experienced more time with cumulative oxidative stress, photoreceptor degeneration and Bruch’s membrane degradation leading to choroidal neovascularization and subsequently wet AMD.
Demographics have created a concentration in the wet AMD market because it takes decades of age-related changes to the retina to develop the necessary conditions for wet AMD to manifest; therefore, elderly populations represent the largest portion of the disease burden and require long-term treatment with anti-vascular endothelial growth factor (anti-VEGF) medications to maintain their ability to function independently and to preserve functional vision in everyday activities.
The rate of use of treatments for wet AMD in patients over 80 years of age is primarily influenced by the fact that Medicare provides full reimbursement for intravitreal injections and anti-VEGF pharmaceuticals under part B medical benefits thereby allowing access to these treatments at minimal cost to patients who have limited financial resources to spend on out-of-pocket costs. According to the World Health Organization (WHO), the number of people worldwide aged 60 or older will be three times higher than it was in the year 2000 approximately 606 million and will reach nearly 2 billion by 2050 which will directly contribute to a larger demographic of people eligible for treatment of wet AMD.
The 40–59 years category will have the highest CAGR, due to an increased incidence of wet AMD in younger populations with earlier onset neovascularization related to genetic predispositions, inflammatory pathways and modifiable risk factors such as smoking, obesity and cardiovascular disease. Growth rates are expected to accelerate due to better availability of optical coherence tomography technology for screening and diagnosis, educational campaigns regarding symptoms of distortion and central vision loss, and the motivation of working-age individuals to seek treatment and maintain their ability to work and participate economically.
The age groups analyzed in this report are:
The intravitreal category holds the largest market share, of 95%, in 2025, and it will have the highest CAGR, driven by the biological requirement for direct retinal drug delivery, strong clinical efficacy of intravitreal anti-VEGF therapy, and sustained reimbursement support across major healthcare systems. This is also reflective of biological necessity, where therapeutic VEGF inhibition can only be achieved within retinal tissue compartments that are inaccessible to systemic pharmaceuticals due to the permeability barrier between systemic circulation and the retina.
U.S. CMS data on Medicare usage of anti-VEGF drugs show that the cost for Medicare for intravitreal injections of these agents rose from USD 2.51 billion in 2014 to USD 4.02 billion in 2019. These increases reflect both the increase in treated populations and the impact of biologics on prices. In summary, the route of administration is clearly intravitreal administration as it represents the majority of all treatments for wet AMD.
The routes of administration analyzed in this report are:
The hospitals & clinics category holds the largest market share, of 75%, in 2025, providing a central role in delivering care via their comprehensive ophthalmology infrastructure, subspecialized retina providers, advanced diagnostic imaging capabilities including optical coherence tomography and fluorescein angiography, and aseptic environments capable of complying with regulations for intraocular drug delivery. According to the Journal of Managed Care & Specialty Pharmacy, due to the need for specialized clinical training and equipment required to administer intravitreal injections, hospitals and specialty ophthalmology practices will be necessary delivery sites for chronic wet AMD care.
The homecare category will have the highest CAGR, of 7.0%, due to the development of long term release products which could reduce the number of injections per year for wet AMD from monthly to quarterly to semi-annually. Homecare can take advantage of the emergence of new technologies such as mobile ophthalmology and home health nurses who are supervised by physicians to deliver care.
Factors driving this growth include convenience for older adults with mobility issues who do not want to make frequent trips to an ambulatory surgery center/hospital, efforts to contain healthcare costs through the use of less expensive community based delivery models instead of hospital outpatient departments, and technology advancement in point of care diagnostic devices enabling patients to monitor themselves at home for changes in disease activity and response to treatment.
The end users analyzed in this report are:
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North America holds the largest market share, of 40%, in 2025, due to comprehensive Medicare coverage for anti-VEGF treatments, the high quality of retinal imaging allowing for the early identification of neovascularizations in patients with wet AMD, and an existing network of providers who deliver large volumes of intravitreal injections at ambulatory surgery centers and specialty eye clinics.
The U.S. dominates the North American wet AMD market in 2025, due to Medicare Part B's reimbursement for the cost of administering anti-VEGF treatments, the widespread adoption of optical coherence tomography which enables clinicians to monitor disease activity and assess treatment responses accurately, and a network of retina specialists who deliver standardized care according to the clinical practice guidelines published by the American Academy of Ophthalmology.
The U.S. FDA has approved multiple drugs for treating wet AMD as anti-VEGF agents, including ranibizumab, aflibercept, and faricimab approved in 2006, 2011, 2019, and 2022. Regeneron Pharmaceuticals, Genentech, and Novartis maintain extensive commercial presence and active R&D pipelines in the region focused on increasing treatment duration and reducing the health economic burden of the need for repeated follow-up appointments and monitoring of wet AMD patients treated with anti-VEGF drugs.
Asia-Pacific will have the highest CAGR, of 6.8%, attributed to the increase in the elderly population in China, Japan, and India due to demographic aging. This population increase creates a large number of new cases of wet AMD, which will lead to an increase in the demand for treatments in this region. Furthermore, there are significant investments being made in the expansion of retinal sub-specialties and improvement in the availability of geographic access to anti-VEGF therapy outside tier-1 urban areas.
Despite accounting for greater than one third of all AMD cases worldwide, the wet AMD treatment penetration rates remain substantially lower than those found in North America and Europe. As a result, wet AMD treatment markets in Asia-Pacific countries offer a substantial amount of growth potential as diagnostic capabilities, specialist availability and insurance coverage mechanisms develop in middle-income economies. BMC Public Health researchers predict that more than 9 million people around the world will lose their ability to see because of AMD by 2050, with a large portion of these individuals residing in the Asia-Pacific region due to the absolute size of the population and the acceleration of aging demographics in the region.
Increasingly, government policies are focusing on vision health and are providing incentives for vision care and eye disease prevention, in part based on economic studies demonstrating the productivity losses and caregiver expenses associated with untreated wet AMD progression. These studies have motivated national health insurance systems to provide coverage for anti-VEGF therapy and negotiate volume-based procurement agreements with manufacturers to reduce the cost per dose of treatment.
China presents the largest country market for anti-VEGF treatment for wet AMD and the country's national reimbursement formulary inclusion will also strengthen its growth. In addition to national reimbursement, the inclusion of anti-VEGF treatments in China's National Reimbursement Drug List (NRDL) and the establishment of centralized volume-based procurement programs have both lowered the cost of treatment and increased the adoption of treatment among Chinese hospitals. Additionally, the National Medical Products Administration (NMPA) in China has approved several accelerated approval pathways for innovative and biosimilar anti-VEGF treatments, thereby increasing access to these products.
India was the fastest growing country in terms of wet Age-Related Macular Degeneration treatment sales in Asia-Pacific, primarily due to the rapidly expanding elderly population projected to reach 300 million by 2050; the increasing incidence of modifiable risk factors including diabetes and hypertension that accelerate the onset of wet AMD; and the increasing availability of specialist ophthalmological services throughout the country resulting from public-private partnerships and the expansion of medical colleges to increase the capacity for fellowship training in retinal surgery.
As part of the National Programme for Control of Blindness and Visual Impairment, the Indian government has prioritized the diagnosis and treatment of wet AMD through the organization of free screening camps and awareness campaigns to educate the public about the importance of recognizing early symptoms. Additionally, the program has provided capital equipment grants to allow the installation of optical coherence tomography units in district hospitals, thereby establishing a diagnostic capability that previously existed only in urban tertiary centers.
Improving insurance penetration through government-sponsored plans including Ayushman Bharat, which covers approximately 500 million individuals, along with the increasing domestic pharmaceutical investment in the development of aflibercept biosimilars to reduce affordability barriers and increase access to treatment, have been key drivers of market growth.
The regions and countries of the market are as follows:
The market is consolidated, dominated by large pharmaceutical companies with ophthalmology portfolios, regulatory approval expertise, and the commercial infrastructure to support the global distribution of anti-VEGF therapies. The high level of concentration in the market results from significant research & development costs associated with developing biological drugs, the rigorous clinical trial programs required to establish safety and efficacy across a wide range of patient populations, and specialized manufacturing capabilities for sterile injectables that meet the stringent quality standards expected in the ophthalmic field. Large pharmaceutical companies maintain their position as competitors through continuous product innovation based on new molecular mechanisms, longer dosing intervals and improved delivery systems to address adherence issues that patients experience using chronic intravitreal injection regimens.
Additionally, strategic partnerships and licensing agreements are key elements in providing access to regional markets, and large multinational pharmaceutical companies are expanding their geographic reach beyond their core markets by developing distribution networks, collaborating on regulatory submissions, and entering into co-promotion arrangements.
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