How many patients do you see per month, on average?

How many total patients does your practice manage?

How many patients with Geographic Atrophy (GA) does your practice manage?

How many intravitreal injections per month do you perform?

How would you best describe your practice? 

• Individual Private Practice
• Retina only Group Practice
• Multi-specialty Group Practice
• Academic
• Other, please specify:

How many years in practice do you have? 

Which of the following best describes your familiarity with the clinical data for Apellis Pharamceuticals’ pegcetacoplan in Geographic Atrophy?

• Highly familiar with data and updates presented at medical conferences.
• Familiar with primary study outcomes, have not followed subsequent updates as closely.
• Unfamiliar with clinical data.

(Respondent asked to view two profiles of Pegcetacoplan) Please rank the relative attractiveness of Profile A vs. Profile B (1 = best, 2 = worst):

Elaborate on your preference or indicate if no preference. 

Please allocate 100 points to each of the following label attributes by how they will impact your expected prescribing decisions for pegcetacoplan in GA. Please allocate more points to the attribute you think is more important:

• Inclusion of monthly and every-other-month dosing on the label.
• Indication to treat both center-point involved (foveal) and extrafoveal GA.
• Data through two years showing an expanded treatment effect with continual therapy.

What is your expected use of monthly vs every other month treatment intervals for pegcetacoplan if the option for every other month treatment is included in the label?

• Monthly: 
• Every Other Month:

What is your expected use of monthly vs every other month treatment intervals for pegcetacoplan if only monthly treatment intervals are included in the label?

• Monthly: 
• Every Other Month:

What is your level of comfort with treating with longer duration intervals than are labeled for pegcetacoplan?

• Low - I would treat strictly to label with rare exception (i.e., there is no treat-and-extend anatomical marker for knowing what benefit is with extended treatment intervals).
• Moderate - Even if only monthly treatment was labeled, I would be comfortable extending to every other month based on my interpretation of the pegcetacoplan Phase 3 data.
• High – If patients cannot maintain every other month intervals, I would be comfortable further extending it in the absence of supportive clinical data (i.e., something is better than nothing)

Apellis has shared data suggesting that the delta in lesion growth relative to sham is increasing with additional time on drug (image with data displayed). Evidence for an increasing treatment effect over time from the ongoing open label extension study would have the following impact on my expected prescribing of pegcetacoplan:

• Highly influential - It is difficult for me to expect a clinically meaningful impact on vision preservation in its absence.
• Moderately influential - I am already comfortable prescribing assuming linear extrapolation of the current treatment effect, but it is interesting.
• Not influential - I do not know how to rigorously interpret this data so am not accounting for it. 

How impactful would evidence of an expanded treatment effect be for the following?

• My decision to start patients on therapy:
• Keeping patients motivated to stay on drug:

In the absence of demonstrable functional benefit on vision, my enthusiasm for using pegcetacoplan is:

• High – Functional vision endpoints in GA are very challenging to assess over a limited follow up interval, and so the fact that the reduction in lesion growth is increasing with time is compelling.
• Moderate – While functional data is important, I expect there to be a benefit to the drug with long term utilization.
• Low – I want to see a definitive functional benefit with the agent, the impact on vision remains conceptual.
• Very Low - I will only be convinced by controlled data showing a functional benefit on vision preservation.

What is your expected approach to prescribing pegcetacoplan: a.      I will actively recommend it to patients that I think are clinically indicated and motivated to go on therapy b.      I will be balanced in describing the risk and benefit profile and let patients decide for themselves c.      I will not recommend this drug and only give it to patients who ask for it d.      Other, please describe:

Differences in Profile A vs Profile B would have the following expected impact on my prescribing decisions:

• Small impact – I expect to rely primarily on my interpretation of the clinical data I have seen and my own experience with the agent. I will make my own decisions about optimal injection frequency, candidate patients, and extrapolation of the long-term benefit of continued pegcetacoplan therapy.
• Medium impact – A label that includes clinical data that support more flexible use of pegecetacoplan will enable broader access and comfort with using in more patient types.
• Large impact – I expect to treat to label and will refer primarily to the clinical data in the prescribing information when informing patients of risk benefit.

 Please rank the following factors as they relate to your expected prescribing decisions for pegcetacoplan in GA (1 = most important, 4 = least important):

• Favorable reimbursement and profit margin for providing injections
• Extent of customer support from sales reps and MSLs
• Quality of label – totality of clinical data, breadth of population, dosing flexibility
• Real world experience and comfort with the agent

How many GA patients are suitable for treatment in your practice?

How many GA patients do you anticipate are in your referral network that may come into your practice with an available therapy?

With respect to the price of anti-VEGF intravitreal injected ophthalmology products, my philosophy is most aligned with the following:

• Higher prices are warranted for premium products
• I am comfortable with the current price range for these drugs
• These drugs are too expensive
• Other, please specify:

What is the most appropriate pricing benchmark for pegcetacoplan?

• Pricing in range with intravitreal anti-VEGF products. This is the most logical reference point and I am currently comfortable purchasing products in this range.
• Pricing at a discount to intravitreal anti-VEGF products. I perceive the relative clinical benefit is lower and think the price should reflect that.
• Pricing at a premium to intravitreal anti-VEGF products. This is a novel mechanism for a different patient population.

Above what price point per vial would you think the cost of pegcetacoplan is inappropriately high? [Pricing sliding scale ($1000 - $3000 per vial)]

What incremental list price premium would be warranted for Label Profile B vs Profile A?

Assuming you intended to use pegcetacoplan in 10 patients in your practice, how would the following list prices impact how many of these patients will go on the therapy:

• $1500 per vial [Answer 0 to 10]
• $1750 per vial [Answer 0 to 10]
• $2000 per vial [Answer 0 to 10]
• $2250 per vial [Answer 0 to 10]
• $2500 per vial [Answer 0 to 10]
• $2750 per vial [Answer 0 to 10]
• $3000 per vial [Answer 0 to 10]

If the rebate provided by the manufacturer is comparable to what you receive with anti-VEGFs, what would the impact to your price tolerance be?

(Respondent show profile for Iveric Bio’s Zimura is also expected to come to the market this year with a label capturing elements of the drug.) Relative to pegcetacoplan, I view the zimura label profile as:

• Better than pegcetacoplan
• Comparable to pegcetacoplan
• Worse than pegcetacoplan

Please comment on your response:

Which of the following best captures my expected utilization of pegcetacoplan relative to zimura:

• I intend to primarily use one agent over the other, depending on which I become more comfortable with and the quality of relationship I develop with the manufacturer.
• I will be relatively indifferent to the use of either agent provided they are competitively priced.
• I expect payer coverage to primarily dictate my utilization irrespective of my preference.
• Other, please specify:

Out of 100 GA patients in my practice, I would anticipate the following distribution:

• Pegcetacoplan: [0-100]
• Zimura: [0-100]
• No treatment: [0-100]

Please rank the following attributes in terms of their impact on your choice between the two agents prescribing behavior [1 – most important, 6 – least important]:

• Contracting negotiations made at the level of my practice
• Relative quality of customer service and support from company reps
• Extent of hands-on experience with one agent over the other
• Agent that is preferred by my patient’s insurance provider
• Differences in the label
• Differences in my interpretation of the safety and efficacy data between the two agents

Do you have any additional comments on this survey or topic?