The global dry age-related macular degeneration market size was valued at USD 1,589.52 million in 2022. It is expected to reach USD 3,193.53 million by 2031, growing at a CAGR of 8.06% during the forecast period (2023–2031).
The eye's small central retinal macula deteriorates due to age-related macular degeneration (AMD) disease. Since it controls how the eye perceives vision, the macula is a crucial part of the retina. Macular health is determined by a person's ability to read, identify, and recognize objects requiring exquisite visual detail. Wet macular degeneration and dry macular degeneration are the two categories of age-related macular degeneration (AMD). Neovascular macular degeneration can progress to wet (neovascular) AMD, characterized by leaking blood vessels developing under the retina. Although it progresses more slowly over time, dry-type occurs more commonly. In general, moist-type tends to cause quick changes in vision that end in significant vision loss.
Growing Geriatric Population and Raising Dry Age-Related Macular Degeneration Prevalence
Dry age-related macular degeneration (AMD) is one of the most common eye disorders in persons over 60. It progressively gets worse with age and is directly related to age. The macula's light-sensitive cells thin out and eventually die as the condition worsens. According to a report released by the United Nations (UN) in December 2020, the world's older population is expanding quickly because of rising life expectancy rates and falling fertility rates. The same report estimates that 727 million people aged 65 or older were alive in 2020 and that by 2050, that number will have increased to roughly 1.5 billion.
In addition, the proportion of people 65 and older is anticipated to rise from 9.3% in 2020 to about 16.0% in 2050. It is also possible to see this in China. According to the UN, the percentage of adults over 65 is expected to rise from 12% in 2020 to 26% in 2050. Among the elderly, AMD is a pervasive disorder. 90% of diagnosed cases of AMD in the US are in dry form, according to a report by the Brightfocus foundation. Additionally, as of January 2019, there were over 11 million AMD patients in the US; by 2050, that number is projected to double to about 22 million.
Rising Healthcare Spending
To support national and international health goals, comprehensive and comparable health spending estimates in each nation are a crucial component of health policy and planning. The World Health Organization (WHO) published a new report on global health expenditure on February 20, 2019, which found that high-income countries saw an increase in health spending of 4% while low and middle-income countries saw an increase of 6%. The same report states that domestic and external funding roles are changing, but external funding is declining in middle-income nations.
Additionally, the government covers less than 40% of the cost of primary healthcare. According to estimates, each US citizen spent more than USD 10,000 on healthcare in 2018. This amount of spending was significantly higher than that of all other OECD nations (after adjusting for differences in country purchasing power). The next-highest spender in the OECD, Switzerland, spent less than 70% of this total, and the average across all OECD nations was less than 40% of the US amount (USD 3,994). The amount of people who adhere to the available treatments is increased by government spending on healthcare and policies relating to healthcare facilities, the distribution of essential medications, and the availability of disposable income. In addition, several investments by manufacturers, venture capitalists, and new products in the global intracranial hemorrhage diagnosis and treatment market are anticipated to fuel market growth in addition to public healthcare spending.
Unsuccessful Clinical Trials and Strict Regulations
The age-related macular degeneration market may experience slower growth due to the government's strict regulations because sudden changes to the regulations and delays in the drug approval process can result in significant financial losses. Several AMD treatment medications have fallen short of FDA accuracy standards recently. For instance, F. Hoffmann-La Roche AG's lampalizumab failed its initial Phase III clinical trial in 2018. It was anticipated that lampalizumab would be used for the first time to treat patients with dry AMD.
In addition, Eculizumab failed in its phase 2 clinical trials, emixustat hydrochloride failed in phases IIb/III, palucorcel by Janssen Pharmaceuticals, which failed to pass the phase IIa clinical trials, were a few other treatments that did not make it through the clinical trials stage. Such unsuccessful clinical trials and strict regulations regarding dry AMD medications may, in part, restrain the market growth during the forecast period.
Pipeline Drugs for Dry AMD
Currently, VEGF inhibitors, Photodynamic Therapy (PDT), and thermal laser photocoagulation are available as treatments for wet AMD. On the other hand, there is currently no proven effective treatment for dry AMD. Also, there is a chance that someone with dry AMD could also develop wet AMD. Therefore, patients are advised to stop smoking and take a specific high-dose formulation of antioxidant vitamins and zinc to slow the progression of the disease. The "AREDS2" formula is thought to be the ideal vitamin combination. However, businesses and research institutions constantly seek a cure for dry AMD. Several drugs are already in development that will fuel market expansion if they pass the clinical trial stages.
The global dry age-related macular degeneration market is segmented by stages, age group, diagnosis and treatment, route of administration, and end-user.
Based on stages, the global dry age-related macular degeneration market is bifurcated into early age-related macular degeneration, intermediate age-related macular degeneration, and late age-related macular degeneration.
The intermediate age-related macular degeneration segment is the highest contributor to the market and is expected to grow at a CAGR of 9.42% during the forecast period. The presence of numerous medium-sized drusen, at least one large drusen, and noncentral geographic atrophy are characteristics of the intermediate stage of AMD. The Retinal Pigment Epithelial cells (RPE) deteriorate and die due to the accumulation of waste products and the blockage of nutrients to the macula caused by the growing number of large drusen. This stage's symptoms include a blurred or blind spot in the center of the vision. Additionally, fundoscopy can reveal the large drusen size and retinal pigment abnormalities at this stage. It suffices to have one or more large drusen (125 mm in the smallest diameter), roughly the width of a significant branch retinal vessel crossing the margin of the optic disc.
Early age-related macular degeneration currently occupies the second-largest market share due to an expanding patient base for AMD. There is no vision loss in early-stage AMD, which can be identified by the presence of medium-sized drusen beneath the retina. The drusen (yellow pigments) are collections of amorphous debris close to the retinal pigment epithelium's basement membrane. In various studies, the prevalence rate of early AMD ranges from 6.7% to 39.3%, and that of late AMD ranges from 1.2% to 2.5%. In addition, nearly everyone over 50 has at least one small druse in either one or both eyes. Large drusen in the eye increase the risk of developing late age-related macular degeneration.
Based on age group, the global dry age-related macular degeneration market is bifurcated into above 75 years, above 60 years, and above 40 years.
The above 75 years segment owns the highest market share and is expected to grow at a CAGR of 7.59% during the forecast period. Due to the increased prevalence of AMD in persons over 75 and other dry age-related factors, this category will dominate the dry age-related macular degeneration market globally by age group in 2022 with a market share of 45.23%. In 2018, 6.4% of patients aged 65 to 74 and 19.7% of patients over 75 had signs of age-related macular disease, according to research based on the Framingham Eye study, which is used to assess the ocular characteristics of examinees such as senile cataract and age-related macular disease.
Adults over 60 may begin exhibiting early signs of age-related issues that could result in vision loss. Due to the emergence of other eye conditions like cataracts, dry eye, diabetic retinopathy, and glaucoma, AMD is rising in the age group over 60. According to the American Optometric Association, a 2019 study found that people with diabetes, hypertension, or taking medications with side effects that could affect their eyes are more likely to experience vision issues. The International Diabetes Federation (IDF) estimates that 463 million people will have diabetes worldwide in 2020. In the global market for dry age-related macular degeneration by age group, this segment has a market share of 33.87%.
Based on diagnosis and treatment, the global dry age-related macular degeneration market is bifurcated into treatment and diagnosis.
The treatment segment is the highest contributor to the market and is expected to grow at a CAGR of 8.32% during the forecast period. In terms of revenue, the treatment segment led the world market for dry age-related macular degeneration in 2022. The two treatment submarkets are nutrition therapy and telescopic lens implant markets for dry age-related macular degeneration. A further division of nutrition therapy is made into antioxidants and other nutrients. Additional categories of antioxidants include vitamins, zinc, copper, Omega-3 fatty acids, and others. Due to new trends, many developing drugs, and cutting-edge treatment methods, the nutrition therapy market segment will hold the largest share of 90.92% in 2022. Furthermore, the market for dry age-related macular degeneration is anticipated to grow during the forecast period due to the rising prevalence of eye-related disorders.
In the global dry age-related macular degeneration market by treatment and diagnosis in 2022, the diagnosis segment holds a market share of 36.87%. The segment is divided into preliminary tests, fluorescein angiograms, optical coherence tomography, and others. Optical coherence tomography (OCT) provides a cross-sectional eye image, which assesses macula thickness and fluid leakage in the retina. A device scans the retina and produces incredibly accurate images of the macula and retina. Based on the type of diagnosis, optical coherence tomography has the largest market share. Fluorescein angiography is an imaging technique in which a patient's arms are injected with a dye that illuminates the blood vessels in the eye as multiple images of the back of the eye are taken.
Based on the route of administration, the global dry age-related macular degeneration market is bifurcated into oral and injectable.
The oral segment owns the highest market share and is expected to grow at a CAGR of 9.04% during the forecast period. The oral method is the most common and is primarily used to treat age-related macular degeneration, with a market share of 64.32% in 2022. The primary preventive strategy to slow the loss of vision is nutrition therapy. Antioxidants are recommended for dry age-related macular degeneration, affecting copper, zinc, and beta-carotenoids. Due to its widespread use in clinical studies, this route of administration currently has the largest market share.
Based on the end-user, the global dry age-related macular degeneration market is bifurcated into hospitals and clinics, diagnostic centers, and academic research institutes.
The hospitals and clinics segment is the highest contributor to the market and is expected to grow at a CAGR of 9.62% during the forecast period. According to end-users, hospitals and clinics dominate the dry age-related macular degeneration market globally. This share is primarily attributable to the rise in patients receiving eye disease monitoring. Patients typically prefer to receive treatment at a hospital because comprehensive and advanced treatments are available there. Additionally, medical care facilities that treat AMD patients include clinics. Most hospitals treating this disease are in developed nations like India, China, Russia, Europe, and the Americas. However, most people, particularly in developing economies, cannot cover these costs due to the high cost of diagnosis and treatment.
The general public or the medical community can receive diagnostic services in a diagnostic center. It also goes by the name Imaging Center. Visual acuity testing, dilated eye exams, Amsler grid physical examinations, and diagnosis using imaging techniques like fluorescein angiogram, optical coherence tomography, and others are all included in the services. The first sign of dry AMD that requires diagnosis is blurred central vision. Due to the rising prevalence of eye diseases, which directly increases the demand for diagnostic centers, diagnostic centers hold the second largest market share. Additionally, dry AMD is diagnosed at all stages of age-related macular degeneration, which encourages the development of diagnostic facilities in this market.
By region, the global dry age-related macular degeneration market is segmented into North America, Europe, Asia-Pacific, and the Rest of the World.
North America is the most significant shareholder in the global dry age-related macular degeneration market and is expected to grow at a CAGR of 8.06% during the forecast period. North America dominated the global market for dry age-related macular degeneration due to the rising number of people affected by the ailment. The number of people with ophthalmologic conditions is growing along with the number of diabetic patients. In addition, a retrospective study presented at The Association for Research in Vision and Ophthalmology 2020 indicated that the prevalence of retinal diseases like dry AMD, retinal vein occlusion, and diabetic eye disease is rising steadily in the US. In contrast to wet AMD, diabetic macular edema, diabetic retinopathy, and other indications, dry AMD, which has a prevalence of 16.3%, has the highest disease burden over six years, according to this study between 2014 and 2019. Furthermore, there was a peak in the prevalence of dry AMD in people aged 80 to 89. Due to rising government funding and initiatives, the dry age-related macular degeneration market is expanding in the North American region.
Europe is expected to grow at a CAGR of 9.28% during the forecast period. The second-largest market share belongs to Europe, which has a growing older and more patient population. The development of the dry age-related macular degeneration market in Europe is being fueled by bettering governmental initiatives, expanding healthcare infrastructure, and rising demand for technologically innovative treatments. For instance, according to projections from Eurostat, the number of older people (those 65 or older) in the EU-27 will rise sharply, from 90.5 million at the beginning of 2019 to 129.8 million by the year 2050. The number of people in the EU-27 aged 75–84 is anticipated to rise by 56.1%, whereas the number of people aged 65–74 is expected to rise by 16.6%. Additionally, it is anticipated that more patients will be diagnosed with various conditions related to vision loss due to new initiatives utilizing big data to analyze many optical coherence tomography results.
The Asia-Pacific region is experiencing the fastest growth rate for age-related macular degeneration due to its rapid development and the emergence of numerous players. The market is expected to grow as a result of the rising prevalence of eye disorders, rising healthcare spending, and multinational corporations expanding into developing countries. In addition, the WHO estimated that developing countries in Asia-Pacific are home to 90% of the world's visually impaired individuals. Due to the rapid development of the healthcare infrastructure in these regions and the rising demand for better healthcare services, India and China are also significant contributors to the market growth.
The rest of the world is expected to see only modest development because of the population's lack of access and expensive costs. Latin America, Africa, and the Middle East comprise this region. The Middle East's expanding healthcare infrastructure and spending fuel the market's expansion. According to a study estimating the prevalence of vision impairment in Sub-Saharan Africa (SSA) in 2020, there will be 4.28 million blind people, 17.36 million people with moderate to severe vision impairment, and 101.08 million people with near vision impairment. Similarly, more research papers on ophthalmic conditions are anticipated to raise awareness of various conditions. The Middle East and Africa have the highest crude prevalence of vision impairment, according to the interactive dashboard of The International Agency for the Prevention of Blindness (IAPB).
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