Provider Briefing: Eylea Supply in 2026

Aflibercept (Eylea) remains one of the most prescribed anti-VEGF agents in retina care — and one of the most challenging to source consistently. Since 2023, intermittent supply constraints have forced practices to adjust treatment protocols, explore alternatives, and manage increasing patient anxiety around injection scheduling.

This article provides a comprehensive, provider-focused update on the Eylea supply situation in 2026, including the timeline of disruptions, prescribing implications, the current availability landscape, cost and access considerations, and tools to help your practice and patients navigate ongoing constraints.

Timeline of Eylea Supply Disruptions

Understanding how we got here is important for anticipating what comes next:

• 2011: FDA approves Eylea (Aflibercept 2 mg) for wet AMD. Rapid adoption follows.
• 2014–2022: Eylea becomes one of the highest-revenue drugs globally, with peak annual sales exceeding $9 billion. Indications expand to include DME, RVO, DR, and ROP.
• 2022: Vabysmo (Faricimab) receives FDA approval, offering the first significant competitive alternative in the anti-VEGF space.
• 2023: FDA approves Eylea HD (8 mg Aflibercept). Intermittent supply constraints begin to emerge across the U.S., driven by manufacturing capacity limitations and sustained global demand.
• 2024: Supply issues persist in certain regions. Practices report allocation-based ordering restrictions and shipment delays.
• 2025–2026: Situation gradually improves as Regeneron increases production capacity and Aflibercept biosimilar applications advance through FDA review. However, localized shortages continue, particularly for smaller practices.

Prescribing Implications

The supply variability has meaningful implications for clinical decision-making:

Treatment Continuity

For patients with wet AMD, DME, or RVO, treatment gaps can lead to disease reactivation and irreversible vision loss. The American Academy of Ophthalmology and the American Society of Retina Specialists have emphasized the importance of maintaining treatment continuity, even if that means switching anti-VEGF agents temporarily.

Switching Protocols

When Eylea is unavailable, the most common clinical approach is to switch patients to an alternative anti-VEGF agent. The evidence supports comparable efficacy across agents for most indications:

• Vabysmo (Faricimab): Non-inferior to Eylea in pivotal trials for wet AMD and DME. Bispecific mechanism (VEGF-A + Ang-2) may offer extended durability.
• Lucentis (Ranibizumab) or biosimilars (Cimerli, Byooviz): Well-established efficacy. Monthly dosing is standard, though treat-and-extend protocols are common.
• Avastin (Bevacizumab): Off-label but supported by major clinical trials (CATT, IVAN). Significantly lower cost (~$50–100 per dose). Requires compounding.
• Beovu (Brolucizumab): Extended dosing potential (q8–12 weeks), but prescribers should weigh the risk of intraocular inflammation and retinal vasculitis.

Eylea HD Considerations

Eylea HD (8 mg) offers the same active molecule at a higher dose, enabling extended dosing intervals of 12 to 16 weeks for eligible patients. If your practice has access to Eylea HD but not the standard 2 mg formulation, transitioning appropriate patients is a reasonable clinical strategy. Note that Eylea HD is currently indicated for wet AMD and DME.

Current Availability Picture

As of early 2026, Eylea availability remains uneven across the U.S.:

• Large retina practices and academic centers generally report adequate supply, benefiting from priority allocation based on historical ordering volumes.
• Smaller independent practices and those in rural or underserved areas are more likely to experience gaps.
• Eylea HD availability has been somewhat more consistent, likely due to lower overall demand relative to the standard formulation.
• Specialty distributors such as McKesson and AmerisourceBergen continue to allocate supply based on purchase history, which can limit access for practices attempting to increase orders.

Cost and Access Landscape

Cost remains a significant factor in anti-VEGF treatment decisions:

• Eylea 2 mg: Average wholesale price (AWP) approximately $1,850–$2,200 per dose
• Eylea HD 8 mg: AWP approximately $1,100–$1,200 per dose
• Vabysmo: AWP comparable to Eylea (~$1,800–$2,200)
• Lucentis biosimilars: ~$1,100–$1,400 per dose
• Avastin (compounded): ~$50–$100 per dose

For practices participating in Medicare Part B buy-and-bill, reimbursement is typically ASP + 6%, which has tightened margins as costs have risen. The availability of Lucentis biosimilars and Avastin provides lower-cost options that can ease financial pressure on both practices and patients.

Patient Financial Assistance

Regeneron's Eylea4U program offers copay assistance for commercially insured patients (as low as $0 copay) and a patient assistance program for uninsured or underinsured individuals. Encourage eligible patients to enroll. Additional resources include patient savings guides that can help patients navigate cost barriers.

Tools and Resources for Providers

Several tools can help your practice manage Eylea supply challenges more effectively:

Medfinder for Providers

Medfinder offers a provider-facing platform that helps retina practices connect with patients who need treatment. If your practice has Eylea in stock, listing your availability on Medfinder can help patients find you. If you're running low, the platform can help you direct patients to other practices with supply.

Distributor Communication

Maintain regular contact with your specialty distributor representatives. Some practices have found success in:

• Providing demand forecasts to distributors
• Establishing backup distributor relationships
• Requesting allocation increases when patient volume warrants it

Patient Communication Templates

Proactive patient communication reduces anxiety and no-shows. Consider providing patients with:

• Written explanations of the supply situation
• Clear instructions on what to do if their appointment is affected
• Links to patient-facing shortage updates they can read at home

Looking Ahead

Several developments could substantially improve the Eylea supply picture in the near term:

• Aflibercept biosimilars: Multiple biosimilar applications are under FDA review. Approval and market entry could occur in 2026 or early 2027, significantly increasing supply and reducing costs.
• Regeneron manufacturing expansion: The company has invested in expanding production capacity to meet global demand.
• Continued Vabysmo adoption: As more practices gain experience with Faricimab, the overall demand on the Aflibercept supply chain may decrease.
• Port delivery system research: Sustained-release technologies could eventually reduce injection frequency and overall drug demand.

Final Thoughts

The Eylea supply situation in 2026 requires a proactive, flexible approach. Maintaining treatment continuity should remain the clinical priority — whether through Eylea, Eylea HD, or an alternative anti-VEGF agent. Leveraging tools like Medfinder for providers, strengthening distributor relationships, and communicating transparently with patients are all essential strategies.

For the patient perspective on this issue, share our patient-facing Eylea shortage update with your patients. And for a practical guide on helping patients locate supply, see our provider's guide to helping patients find Eylea.