DelveInsight flags poor drop adherence

Open-angle glaucoma is usually treated by lowering pressure inside the eye, and for many patients that still means taking drops every day for years. DelveInsight says that routine remains the market’s center of gravity even as adherence repeatedly breaks down outside the clinic. (delveinsight.com) (springer.com) The standard drug classes are familiar: prostaglandin analogs, beta blockers, carbonic anhydrase inhibitors, alpha agonists, and newer rho kinase inhibitors. The problem is less whether the drops can lower pressure than whether patients can keep using them correctly month after month. (pmc.ncbi.nlm.nih.gov) (eyewiki.aao.org) A 2025 systematic review of prostaglandin analog use found wide variation in real-world adherence and persistence, underscoring how quickly daily regimens can erode. DelveInsight’s pipeline report puts that commercial and clinical gap at the center of the next wave of glaucoma development. (ajo.com) (delveinsight.com) That pipeline is not small. DelveInsight says more than 18 companies are developing over 20 candidates for open-angle glaucoma, spanning clinical and nonclinical programs, delivery routes, and molecule types. (delveinsight.com) The most visible answer is to move medicine off the bathroom counter and into the clinic. Sustained-release implants and other provider-administered treatments aim to deliver pressure-lowering drugs over months, reducing the number of daily decisions a patient has to get right. (springer.com) (reviewofophthalmology.com) Some of that shift is already happening in the market. The Food and Drug Administration approved Durysta, a bimatoprost intracameral implant, for open-angle glaucoma or ocular hypertension in 2020, and approved iDose TR, a travoprost implant, in December 2023. (accessdata.fda.gov 1) (accessdata.fda.gov 2) The FDA pushed that trend further on January 28, 2026, when it approved a labeling supplement allowing repeat administration of iDose TR. Glaukos said the decision was based on clinical evidence supporting the safety and tolerability of repeat use. (investors.glaukos.com) Laser treatment is part of the same story. The American Academy of Ophthalmology’s 2025 Primary Open-Angle Glaucoma Preferred Practice Pattern says prostaglandin analogs and selective laser trabeculoplasty can both be considered initial treatment in appropriate patients. (aao.org) That leaves the field in an awkward middle ground. Daily drops still dominate long-term care, but the newest investment and regulatory movement are clustering around treatments designed to work even when adherence does not. (delveinsight.com) (investors.glaukos.com) DelveInsight’s report reads less like a claim that drops are disappearing than a map of where companies think the bottleneck is. In glaucoma, the next contest is not only lowering eye pressure, but doing it without asking patients to remember another bottle tonight. (delveinsight.com)