Aflibercept 2 mg remained the most commonly used anti-VEGF therapy in the United States from 2017–2023, but faricimab showed the fastest growth in use after its 2022 launch, with treatment patterns varying by insurance type, according to a presentation at The Retina Society 58th Annual Scientific Meeting.
Researchers reviewed more than 571,000 injections recorded in the Epic Cosmos database, which includes de-identified electronic health record data from 238 million patients nationwide. Aflibercept 2 mg accounted for more than half of all injections during the study period (53.6%), followed by bevacizumab (34.8%), ranibizumab (7.8%), and faricimab (3.4%). Other anti-VEGF agents, including brolucizumab and aflibercept 8 mg, made up less than 1% of use.
Utilization trends varied over time. Rates of aflibercept and bevacizumab injections both more than doubled from 2017 to 2023, while ranibizumab use declined. Faricimab, first introduced in 2022, showed the sharpest growth, with utilization climbing nearly 5-fold in just 1 year.
Insurance status also influenced treatment patterns. Medicare beneficiaries were significantly more likely to receive aflibercept compared with bevacizumab or faricimab, which was not observed in patients covered by commercial insurance or Medicaid.
Reference
Parikh R, et al. Changes in Access and Utilization of Faricimab, Aflibercept, Ranibizumab and Bevacizumab Across Insurers in the United States. Presented at: Retina Society Annual Meeting; September 2025; Chicago, IL.
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