Roche's Susvimo: Redefining nAMD Treatment Through Innovation and Long-Term Durability

Neovascular age-related macular degeneration (nAMD) remains a leading cause of irreversible vision loss in the aging global population. For decades, the standard of care has relied on monthly intravitreal injections of anti-VEGF therapies like Lucentis and Eylea. However, Roche's Susvimo—a port delivery system that continuously administers ranibizumab to the eye—has emerged as a disruptive force. With five-year clinical data now available, the investment community must reassess Susvimo's transformative potential, particularly its ability to deliver sustained durability, reduce treatment burden, and carve out a unique market position in a highly competitive therapeutic landscape.

Long-Term Durability: A Pillar of Sustainable Value

The Phase III Portal study (n = 352) has demonstrated Susvimo's ability to maintain vision and retinal stability over five years. Approximately 95% of patients required no supplemental treatment between six-month refills, with best-corrected visual acuity (BCVA) remaining stable at around 68 letters in both the Susvimo and IVT-Susvimo cohorts. Half of participants retained better than 20/40 vision, a critical threshold for functional independence. Central subfield thickness (CST), a marker of retinal fluid, remained stable with minimal changes, underscoring the therapy's anatomical efficacy.

This durability is a stark contrast to traditional anti-VEGF therapies, which often require monthly injections and face challenges with adherence and suboptimal outcomes. For investors, Susvimo's ability to deliver consistent, long-term results reduces the risk of disease recurrence and associated healthcare costs, positioning it as a high-value proposition for payers and providers prioritizing cost-effectiveness.

Reduced Treatment Burden: A Game Changer for Patient Outcomes

Susvimo's port delivery system eliminates the need for frequent injections, a major limitation of existing therapies. The system, implanted during a one-time outpatient procedure, requires refills only twice annually, drastically reducing the number of clinic visits and injections from 12–15 per year to just two. This convenience is particularly appealing for elderly patients, who often struggle with the physical and psychological burden of monthly treatments.

The impact on patient adherence is profound. Traditional therapies face a 20–30% non-adherence rate due to the invasiveness and frequency of injections. Susvimo's model mitigates this risk, ensuring sustained drug delivery and consistent disease control. For biopharma investors, this translates to a more predictable revenue stream and reduced churn, as patients are less likely to discontinue therapy due to treatment fatigue.

Market Differentiation: Navigating a Crowded Therapeutic Landscape

The nAMD market is highly competitive, with established players like Regeneron's Eylea and emerging therapies such as Vabysmo (Regeneron) and Byooviz (Samsung/Biogen). While Eylea remains the market leader due to its robust clinical data and reimbursement infrastructure, Susvimo's unique delivery mechanism offers a compelling alternative.

• Eylea and Avastin: Eylea's monthly or bimonthly dosing and Avastin's off-label use (despite cost advantages) highlight the limitations of traditional anti-VEGF therapies. Susvimo's continuous delivery model addresses these gaps, offering a middle ground between cost, efficacy, and convenience.
• Vabysmo: Vabysmo's dual inhibition of VEGF and Ang-2 allows for extended dosing intervals, but it still requires injections every 16 weeks. Susvimo's six-month refill schedule remains unmatched in terms of reducing treatment frequency.

Despite its advantages, Susvimo's adoption has been gradual, hindered by procedural complexities and reimbursement challenges. However, its five-year data, presented at the American Society of Retina Specialists (ASRS) 2025 Annual Meeting, has bolstered confidence in its safety and efficacy. Roche's strategic focus on personalized healthcare and innovation further strengthens its market position.

ROI and Investment Outlook

The biopharma ROI for Susvimo hinges on three factors: clinical differentiation, market access, and long-term durability.

1. Clinical Differentiation: Susvimo's unique delivery system and five-year data provide a strong value proposition for patients and providers prioritizing convenience and sustained outcomes.
2. Market Access: While reimbursement hurdles persist, the growing emphasis on value-based care and reduced treatment burden may drive broader adoption. Roche's partnership with payers and providers to streamline reimbursement pathways will be critical.
3. Long-Term Durability: The five-year results validate Susvimo's role in reducing the long-term economic burden of nAMD, making it attractive to payers seeking cost-effective solutions.

Conclusion: A Compelling Case for Long-Term Growth

Roche's Susvimo represents a paradigm shift in nAMD treatment, leveraging innovation to address unmet needs in durability, convenience, and patient adherence. While adoption has been incremental, the therapy's five-year data and Roche's commitment to sustainability position it as a key driver of growth in the ocular therapeutics market. For investors, Susvimo's potential to capture market share in a $10 billion+ nAMD space—while reducing treatment burden and improving outcomes—makes it a compelling long-term opportunity.

As the global population ages and demand for effective, convenient therapies rises, Susvimo's unique value proposition will likely drive sustained ROI, cementing Roche's leadership in biopharma innovation.