Summary: comparator Medicare Part B payment limits

No price, average sales price, or wholesale acquisition cost has been announced for 4D-150. For intravitreal anti-VEGF comparators, Medicare Part B payment limits effective July 1 to September 30, 2026 (based on first-quarter 2026 ASP data) were $743.605 per 1 mg for aflibercept (J0178), $298.683 per 1 mg for aflibercept HD (J0177), $803.255 per 1 mg for aflibercept-ayyh (Q5147), $32.381 per 0.1 mg for faricimab-svoa (J2777), $51.090 per 0.1 mg for ranibizumab (J2778), $240.972 per 0.1 mg for ranibizumab-nuna (Q5124), $82.528 per 0.1 mg for ranibizumab-eqrn (Q5128), $74.795 per 0.1 mg for ranibizumab via the Susvimo implant (J2779), $359.713 per 1 mg for brolucizumab-dbll (J0179), and $74.823 per 10 mg for bevacizumab (J9035), each with 20% coinsurance. At labeled nAMD doses these limits correspond to $1,487.21 per aflibercept 2 mg injection, $1,606.51 per aflibercept-ayyh 2 mg injection, $2,389.46 per aflibercept 8 mg injection, $1,942.86 per faricimab 6 mg injection, $255.45 per ranibizumab 0.5 mg injection, and $2,158.28 per brolucizumab 6 mg injection (calculated).

Sponsor statements on anticipated pricing of 4D-150

“Pricing was not disclosed, but the company said 4D-150 would likely be priced well above a single intravitreal anti-VEGF injection.” (opens the source at this quote in a new tab)

“In addition, we expect the relatively low doses required to allow for favorable manufacturing scalability, cost of goods sold, and pricing flexibility compared to conventional IV genetic medicines.” (opens the source at this quote in a new tab)

Comparator wholesale acquisition costs: aflibercept 8 mg and faricimab, 2025

“Direct costs were estimated based on modeled mean injection numbers and 2025 wholesale acquisition costs per injection (aflibercept 8 mg: 2677.50 USD; faricimab: 2289.65 USD) plus medical monitoring costs.” (opens the source at this quote in a new tab)

Comparator Medicare Part B average spending per claim, 2025

HCPCS code	Brand name	Average spending per claim, 2025 (Q1-Q4)
J0178	“EYLEA”	“1792.4254857”
J0177	“EYLEA HD”	“3006.5947467”
Q5147	“PAVBLU”	“2010.6720252”
J2777	“VABYSMO”	“2390.9037697”
J2778	“LUCENTIS”	“542.43913909”
Q5128	“CIMERLI”	“880.821349”
Q5124	“BYOOVIZ”	“706.41442336”
J2779	“SUSVIMO”	“7460.7805379”
J0179	“BEOVU”	“2267.6140542”

Wholesale acquisition cost of a one-time ocular gene therapy: voretigene neparvovec

“On January 3, 2018, Spark Therapeutics, Inc., announced that the wholesale acquisition cost for LUXTURNA™ (voretigene neparvovec-rzyl) is $425,000 per dose or per eye.” (opens the source at this quote in a new tab)

Average sales price methodology for physician-administered agents under Medicare Part B

“Under Medicare Part B, physician-administered drugs are reimbursed based on an average sales price methodology (average sales price + 6%, effectively reduced by sequestration).” (opens the source at this quote in a new tab)

Effect of billing code attribution on reported reimbursement per bevacizumab injection

“In our primary analysis, unspecified codes (e.g., J3490, J3590, and J7999) were attributed to bevacizumab based on established billing precedent. Sensitivity analyses excluding these codes demonstrated that mean reimbursement remained stable at approximately $50 per injection, consistent with historical pricing patterns.” (opens the source at this quote in a new tab)
“Thus, the observed increase in reimbursement in later years likely reflects coding attribution and billing structure rather than true changes in drug cost, clinical demand, or therapeutic preference.” (opens the source at this quote in a new tab)