Regeneron

Regeneron is based in Tarrytown and discovered Eylea, the aflibercept injection for wet age-related macular degeneration and other retinal diseases. Bayer sells Eylea outside the United States, so US clinics are Regeneron's own commercial territory.

Eylea HD extended the dosing interval, and biosimilar aflibercept has given clinics a cheaper syringe. Roche's Vabysmo is the branded rival that retina specialists consider when they want longer time between injections.

Dupixent profits are shared with Sanofi, which means Regeneron's second large franchise is detailed by a partner and reimbursed as a pharmacy benefit, unlike Eylea, which is buy-and-bill in the office. Libtayo adds a smaller oncology antibody to that mix.

Retina practices that stock Eylea carry inventory and a payer mix of buy-and-bill versus pharmacy benefit.

Biosimilar aflibercept and Vabysmo are the two different threats, one on price and one on dosing interval.

Dupixent economics move with Sanofi's contracting, not with Regeneron's retina sales force alone.

Patients on a retinal injection schedule notice a switch as a change of syringe, interval, or copay.

Office managers who buy and bill Eylea watch reimbursement, because a denied vial is their receivable.