Q&A: Pharmacists Play Key Role in Retinal Therapy Support | Asembia 2025

Advancements in retinal disease treatment are easing burdens for patients with conditions like age-related macular degeneration and diabetic retinopathy. New therapies such as high-dose aflibercept and faricimab allow for longer intervals between injections, improving convenience and adherence. Casey Koch, PharmD, MBA, BCACP, clinical pharmacy coordinator at SelectHealth, notes future options may include gene therapies and multi-targeted antibodies with even longer-lasting effects.

Q&A: Pharmacists Play Key Role in Retinal Therapy Support | Asembia 2025 / maxsim - stock.adobe.com

Despite innovation, treatment remains costly for many patients. Pharmacists can assist by connecting patients to copay and foundation support programs, counseling on affordability options, and guiding them toward biosimilars or compounded alternatives when appropriate.

Drug Topics® sat down with Koch at Asembia’s AXS25 Summit, held April 27 to May 1 in Las Vegas, Nevada, to discuss treatments on the horizon for the treatment of diabetic macular edema, how pharmacists can reduce patient burden for patients with neovascular age-related macular degeneration, and what role pharmacists can play to improve rates of treatment adherence.

READ MORE: Pharmacist Support Is Key to Retinal Therapy Success | Asembia 2025

Drug Topics: What are some of the treatments on the horizon for the treatment of diabetic macular edema?

Casey Koch, PharmD, MBA, BCACP: We have some novel therapies recently introduced to the market. We have a high dose of aflibercept. We also have faricimab. That is a bispecific antibody. We're seeing with those drugs the potential to push out the dosing interval. We're out to 12 weeks, 16 weeks in some scenarios. That's really where the novelty is right now. In the future, we may see additional targets, potentially some bispecifics, or even trispecifics, hitting 2 or t3 targets within the eye. There's also the potential for gene therapy, which can have a potential to have a really long lasting effect for patients.

Drug Topics: How can pharmacists reduce patient burden for patients with neovascular age-related macular degeneration?

Koch: I think the treatment burden really comes in a couple of factors, the first being how often the patients do have to inject medication. We're seeing some of the novelty in pushing out that duration for how long patients can go. If patients are able to dose less frequently, that not only helps them with their daily lives, but also, they're not having as many medications. They're not having to pay for as many injections. I think the second biggest thing is the cost share to the patient. These are generally a medical benefit on a coinsurance, so their patients are going to pay a portion of the cost for medication.

I think an area where pharmacists can get involved is within that copay assistance or foundation assistance for patients. It is available so you can counsel patients. If they're discussing that they're unable to afford their medications, there may be some help out there. Also, there are some lower cost options. Patients really are having some issues with the cost share. There are off label compounded Avastin, which is a low cost option, and we're hopefully seeing some biosimilar competition here in the near future that should push the prices down .

Drug Topics: What is the importance of treatment adherence, and what role can pharmacists play to improve adherence?

Koch: Adherence is of utmost importance for these patients. The drugs are extremely effective as long as they're taken as often as needed. If a patient gets behind on their medications, it could lead to permanent vision loss. When you're talking to patients, you definitely want to assess whether or not they're able to get in to see their appointments. Oftentimes, patients have trouble getting to their appointments. It's a spot where pharmacists can get involved.

I think a big counseling point is, initially with these medications, you may not see a big change to your vision within the first bit of time. We know this with a lot of medications, but if patients don't actually feel anything, they may give up. That's a spot where you want to counsel with patients that long term, the drugs are extremely effective. Additionally, if patients are on a medication for a longer term and their vision is doing well, some patients may think that they can then give up on therapies as their vision is doing well. That's really not the case. These are lifelong medications. The disease will return if they're not receiving the individual objections.

Read More of Our Coverage: Asembia Specialty Pharmacy Summit

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