Miebo (perfluorohexyloctane ophthalmic solution, Bausch + Lomb) and Xdemvy (lotilaner ophthalmic solution 0.25%, Tarsus Pharmaceuticals) have rapidly become integral to dry eye disease (DED) and Demodex blepharitis treatment strategies. Both medications have demonstrated impressive performance in their first year on the market, exceeding expectations from phase 3 trials.
Market Performance
Miebo, designed to reduce evaporation and inflammation from desiccation stress, generated approximately $25 million in sales in the final months of 2023. By the end of the third quarter of 2024, sales reached $137.6 million, totaling $162.6 million for its first full year. Conservative estimates project over $170 million in sales for 2024. To date, 18,000 eye doctors have prescribed Miebo, with a significant portion writing multiple prescriptions. Bausch + Lomb has secured insurance coverage for roughly 70% of commercially insured patients and 50% of those in government programs.
Xdemvy, targeting Demodex blepharitis, faced the challenge of raising awareness for a lesser-known condition. In its first 12 months, Tarsus reported approximately $126 million in sales by the close of the third quarter of 2024. Around 13,000 eye doctors have prescribed Xdemvy, with 70% writing more than one prescription. Impressively, approximately 80% of insured Americans have coverage for Xdemvy, achieved with an average discount of 40%.
Clinical Outcomes
New clinical data presented at recent conferences highlights the rapid action of Miebo. Studies indicate meaningful relief from the most bothersome DED symptoms, awareness of DED, and vision fluctuation within just 3 days, with continued improvement observed on days 7 and 14.
Tarsus presented data at the Tear Film & Ocular Surface Society meeting demonstrating Xdemvy's impact on meibomian gland disease. The study showed an increase in the number of glands producing and expressing oil at treatment days 43 and 85, with improvements seen in more than three glands. Patients also reported significant improvements in visual fluctuation, itching, burning, and redness on the visual analog DED scale at days 43 and 85.
