• Brittany Kwan

Drug Production in Ophthalmology: Biosimilars and Biobetters


With drug production being one of the largest industries in the world, oftentimes there are exorbitant costs when it comes to treating the eyes. Many patients struggle to afford eyecare, resulting in the discontinuation of treatment. However, the emerging development of “Biobetters” is highly anticipated to combat this issue, as it continues to be marketed as the ophthalmology community’s newest development.


While Biobetter and Biosimilar sound like made-up words, Biobetter suggests any chemically-modified drug product, where its amino acid sequence is altered, or requires an alternative purification process. According to the World Health Organization, Biosimilar refers to “a biotechnological product comparable to an approved reference product in quality, nonclinical, and clinical evaluation”. This means that they are similar to a drug already available in the market.


Both products have their respective benefits and drawbacks. While Biobetters are chemically-modified, they are known to have a longer shelf life and improving pharmacological effects, making them seemingly better drug treatments for patients. In contrast, because a Biosimilar’s chemical identity (ex. amino acid sequence) is reliable and recognized by production, a majority of the time it also produces similar indexes in safety and efficacy as well, meaning guaranteed safety for patient use.


However, according to the International Journal of Retina and Vitreous, even though Biobetters are “better than the [original reference product] in one or more parameters,” they require significantly larger investments: more time and more research. This conflict is seen with the recent focus in Anti-VEGF (anti-vascular endothelial growth factor) therapies, which inhibit abnormal blood vessel growth. Many global patents for Biobetter products like Lucentis, Avastin, and Eylea are set to expire in 2023. As a result, many Biosimilars are needed for approval or development to overcome the demand for Anti-VEGF therapies.


Overall, Biosimilars and their respective reference products need to improve at a quicker pace. This may be possible through the advancing manufacturing and purification techniques. In the future, ophthalmologists need to be aware and have in-depth knowledge about these two drugs, before “these molecules take over the mainstream market”.


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