I believe the story is this:
So the funding from GoodDays is specifically from the chronic disease fund/macular medications section. The funding comes from donations, and in this case, most of it came from Regeneron. Regeneron was happy to do this because most of the funding went to pay for Eylea. This was a win-win situation - the donation to Good Days is a tax writeoff, and the funding helped Eylea maintain market share, while patients had their medications covered. If this sounds like a legal way to get around their version of Stark law/anti-kick back rules, well...it was.
What changed from 2024-2025 didn't occur during that time period, it was before. Once Vabysmo came onto the market, it started to eat into Eylea's lion share. It didn't really start to snowball until later on when Vabysmo received more FDA approvals and EyleaHD didn't take off as well as Regeneron wanted it to - not surprising since Vabysmo is cheaper than EyleaHD. Now with that and Pavblu in the market, it's harder for Regeneron to maintain its past market share, and because of that, they pulled funding since they don't want to be funding their competitors. In a vacuum I don't blame Regeneron for that, but obviously its going to affect patient care significantly.
Genentech offered to match it but the independent board running it wants funds to be equitable from contributors instead of one company using Good Days as a way to establish market share. So now it's a game of chicken from both big pharma and Good Days. Ask the reps and you may or may not get a response, since these decisions are being held close to the chest of the main players.
The squeeze on top of this is that Avastin costs are going up but reimbursements are not. At this rate you might need to dust off your focal laser settings.
Was trying to follow this as a non-optho and chatGPT came in clutch haha:
"The post you're referring to outlines a behind-the-scenes look at how pharmaceutical funding, market dynamics, and patient assistance programs like Good Days interact — especially in the context of expensive medications for chronic and vision-related conditions like macular degeneration.
Here’s an expanded version with more background, context, and explanation of what's being said:
Expanded Explanation:
1. The Role of Good Days and Regeneron's Strategy:
Good Days is a charitable organization that helps patients pay for their medications, especially in expensive categories like chronic diseases and macular medications. The funding for these programs comes from donations — often from pharmaceutical companies themselves.
In this case,
Regeneron (maker of
Eylea and
EyleaHD) donated to Good Days. It was a strategic move:
- Tax benefits: These donations are likely tax-deductible.
- Market share protection: By funding a program that pays for Eylea, they help patients afford their product, indirectly boosting its use and maintaining its dominance in the market.
The post implies that this setup skirts the edge of laws like the
Stark Law and
Anti-Kickback Statute, which are designed to prevent conflicts of interest in medical referrals and treatment decisions. While technically legal, the setup seems ethically murky — it benefits patients, yes, but also protects a company’s commercial interests.
2. The Disruption: Vabysmo and Pavblu Enter the Market
Between 2024 and 2025, big changes happened — though the shift started even earlier:
- Vabysmo (Roche/Genentech) entered the market and offered a cheaper alternative to Eylea, which started eroding Regeneron’s market share.
- Over time, Vabysmo gained more FDA approvals, increasing physician confidence and expanding its potential use.
- Meanwhile, EyleaHD, Regeneron’s new formulation, didn't gain the traction they hoped for.
With both
Vabysmo and Pavblu now available and gaining ground, Regeneron’s response was to
pull back funding from Good Days — likely because continuing to donate would help pay for competitor drugs under the same assistance program.
3. The Standoff: Market Equity vs. Strategic Giving
Genentech reportedly
offered to match Regeneron’s donations, but the board running Good Days
refused to allow companies to control the flow of funds in ways that benefit one specific brand.
This created a
stalemate:
- The board wants equity across all brands, not favoritism.
- Big pharma companies want leverage and return on their donations.
So now,
Good Days is underfunded, and
patients are left in the lurch, caught between pharma politics and nonprofit governance.
4. The Final Blow: Rising Avastin Costs
Avastin, a lower-cost off-label alternative for eye conditions, is also becoming
less viable:
- Its cost is going up, likely due to manufacturing, distribution, or policy changes.
- But reimbursement rates are not increasing, which squeezes doctors financially.
- As a result, physicians may have to go back to older treatment methods, like focal laser therapy, which is less desirable but more affordable.
What This All Means:
- Patients lose out when pharma companies withdraw assistance funding.
- Doctors face difficult choices, with rising costs and reimbursement pressures.
- Market competition, while good in theory, is making assistance programs more contentious.
- The nonprofit middlemen (like Good Days) are being forced into gatekeeper roles, trying to maintain fairness while stuck between corporate interests."
