Duravyu (vorolanib intravitreal insert)

No price, product-specific sales forecast, budget impact model, cost-effectiveness analysis, or health technology assessment has been published for the vorolanib intravitreal insert (DURAVYU, EYP-1901), and no Institute for Clinical and Economic Review assessment of neovascular AMD therapies was identified. The product is investigational: the first phase 3 trial (LUGANO) did not meet its primary non-inferiority endpoint in the full dataset, the second (LUCIA) is expected to report in the fourth quarter of 2026, and EyePoint plans a potential NDA submission in the first half of 2027. EyePoint describes wet AMD and DME together as a "$15B+ global market opportunity" and states that it may need pharmacoeconomic studies to secure coverage and reimbursement.

The budget effect would depend mainly on the insert's price relative to the anti-VEGF injections it displaces and on the number of injections avoided. In LUGANO, treatment burden was reduced by 42% versus on-label aflibercept 2 mg, which the company stated "translates to two fewer injections on average" through week 56, and 54% of participants receiving the insert needed no supplemental injection through week 56. The comparator budget is concentrated in Medicare Part B: in 2024, fee-for-service Medicare spent $3.0 billion on Eylea and Eylea HD (329,500 users; $9,200 per user) and $1.9 billion on Vabysmo (173,300 users; $11,100 per user). By billing code, 2024 Part B spending was $2.37 billion for aflibercept 2 mg, $666 million for aflibercept 8 mg, $1.92 billion for faricimab, and $162 million for bevacizumab across all indications. A U.S. cost-utility model used CY2024 national payments of $125.28 per intravitreal injection (CPT 67028) and $157.64 per follow-up office visit, costs that recur with each injection visit.

Models of other durable anti-VEGF options indicate that savings from fewer injections depend on price and on the comparator. The ranibizumab port delivery system, the approved sustained-delivery comparator, cost more than bevacizumab injections in all scenarios and required 10.8 ranibizumab or 9.3 aflibercept injections to break even with 1 refill; it was cost effective versus ranibizumab injections at 1 year ($75,497 per QALY) but not at 5 years ($304,108 per QALY). Faricimab was dominant over aflibercept 2 mg in a 5-year U.S. payer model (22.6 vs 34 injections), with results most sensitive to acquisition prices. In a U.S. payer budget impact model of brolucizumab for a 1-million-member plan, the annual budget effect ranged from a saving of $94,170 to an increase of $824,696 depending on the dosing regimen assumed. Managed care stakeholders reported that many or most payers require off-label bevacizumab first, and a cost-neutral pricing analysis in a single-payer setting found that first-line use of newer agents required price reductions of 84% to 98% relative to bevacizumab. Budget impact for the vorolanib intravitreal insert therefore cannot be estimated from public data as of September 2026.