Private faricimab (Vabysmo) wet AMD injection cost

UK 2026 self-pay private faricimab (Vabysmo) costs £1,100–£1,650 per injection, all-inclusive at CQC-registered medical retina centres. The fee covers the consultant medical retina assessment, OCT macular imaging (and OCT angiography where indicated), the day-case intravitreal injection of 6mg faricimab under sterile clean-room conditions, the immediate post-injection IOP and vision check, and an OCT review at the next treat-and-extend visit. A typical year-1 course is 7–8 injections (four monthly loading doses then treat-and-extend), totalling £7,700–£13,200; in maintenance years 2+ the annualised burden falls to 4–6 injections per year (£4,400–£9,900), with up to 60% of patients on Q12 or Q16 dosing by year 2.

What is faricimab (Vabysmo)?

Faricimab (Vabysmo, Roche, formerly RG7716) is a humanised bispecific monoclonal antibody (CrossMAb format) that simultaneously binds and neutralises two distinct cytokines driving macular neovascularisation, leakage and inflammation: vascular endothelial growth factor A (VEGF-A) and angiopoietin-2 (Ang-2). VEGF-A is the master regulator of pathological angiogenesis and macular vascular permeability and is the target of all the established intravitreal anti-VEGF agents (aflibercept, ranibizumab, bevacizumab, brolucizumab). Ang-2 is a Tie2-receptor antagonist that destabilises the existing vasculature, sensitises endothelial cells to VEGF-A and amplifies inflammatory signalling; in wet AMD, DMO and RVO, Ang-2 is over-expressed and contributes to chronic leakage, pericyte loss and inflammation. Faricimab is the first and currently only intravitreal therapy that targets both VEGF-A and Ang-2, and the dual mechanism is the biological basis for its ability to extend the treatment interval safely to up to 16 weeks (Q16) in around 60% of patients by year 2 in TENAYA and LUCERNE.

Faricimab is supplied as a single-use sterile glass vial containing 6mg / 0.05ml. It is administered as a day-case intravitreal injection through the pars plana (3.5mm posterior to the limbus in pseudophakic eyes, 4.0mm in phakic eyes) under topical anaesthetic with povidone-iodine surface preparation and a sterile drape, in a clean-room or sterile minor procedure room. The injection itself takes seconds; the total visit (vision testing, IOP, slit-lamp, OCT macula, the injection and immediate post-injection check) takes 60–90 minutes.

The licensed schedule for wet AMD is four monthly loading doses, followed by a treat-and-extend protocol where the interval between injections is extended by 4 weeks at a time if the OCT macula is dry and the BCVA is stable, and shortened by 4 weeks if there is recurrent fluid or visual decline. Intervals run from Q8 (every 8 weeks) up to Q16 (every 16 weeks). For diabetic macular oedema (DMO) and macular oedema secondary to retinal vein occlusion (BRVO, CRVO) the loading schedule and treat-and-extend approach are similar, with disease-specific NICE guidance. You can read more on our wet AMD condition guide and our private anti-VEGF wet AMD injections overview.

UK 2026 faricimab (Vabysmo) pricing, in detail

UK 2026 faricimab pricing varies with the centre overhead, the drug procurement cost (the list price of a single Vabysmo 6mg vial is typically £600–£850 before NHS or hospital procurement rebate), the seniority of the medical retina consultant, the imaging included (OCT alone vs OCT plus OCT angiography vs OCT plus OCT-A plus FFA / ICG), and the post-injection monitoring schedule. The fee should be quoted as an all-inclusive per-injection package, with an itemised year-1 and maintenance-year budget provided.

Related medical-retina fees that may be itemised separately: a consultant medical retina assessment is £295–£495 (vision, IOP, slit-lamp dilated fundus, OCT macula, OCT-A where indicated; usually deducted from the first injection fee if you proceed); standalone OCT macula £125–£225; OCT angiography £195–£325; fundus fluorescein angiography (FFA) £295–£495; and indocyanine green angiography (ICG) £395–£595 (used for suspected polypoidal choroidal vasculopathy and retinal angiomatous proliferation). Alternative agents are also available: aflibercept 2mg (Eylea) £900–£1,400, aflibercept 8mg (Eylea HD) £1,200–£1,750, and ranibizumab (Lucentis) £850–£1,300. You can spread the cost with 0% finance; compare the high-dose aflibercept option on our Eylea HD 8mg cost page, and read more on dry AMD and wet vs dry AMD treatment options 2026.

What should be included in a private faricimab package?

• Medical retina consultant — a UK GMC specialist-registered consultant ophthalmologist with documented medical retina fellowship, doing a high volume of intravitreal anti-VEGF therapy (typically 1,000 or more injections per year), with audit data on per-injection endophthalmitis rate (target less than 0.05%), intra-ocular inflammation rate and 1-year and 2-year BCVA outcomes available on request.
• Full medical retina work-up — best-corrected visual acuity (logMAR / ETDRS), IOP, slit-lamp dilated fundus examination, swept-source or spectral-domain OCT macula, OCT angiography for the neovascular complex, fundus fluorescein angiography (FFA) where indicated, and indocyanine green angiography (ICG) for suspected polypoidal choroidal vasculopathy (PCV) or retinal angiomatous proliferation (RAP).
• Indication confirmation — neovascular (wet) AMD on OCT and OCT-A (intra-retinal fluid, sub-retinal fluid, pigment epithelial detachment, type 1/2/3 neovascular complex); diabetic macular oedema with central retinal thickness above the OCT-defined threshold and BCVA criteria per NICE TA799; macular oedema secondary to BRVO or CRVO with similar OCT and BCVA criteria.
• Treatment plan — treatment-naive patients: four monthly faricimab loading doses then treat-and-extend Q8 up to Q16. Switch patients (from aflibercept 2mg, ranibizumab) unable to extend: 1–2 monthly faricimab loading doses then treat-and-extend. Personalised on prior treatment response and OCT phenotype.
• Day-case clean-room intravitreal injection — topical anaesthetic, povidone-iodine surface preparation, sterile drape and lid speculum, pars plana 30-gauge injection at 3.5mm (pseudophakic) or 4.0mm (phakic) posterior to the limbus, immediate post-injection IOP and vision check.
• Post-injection care — topical antibiotic (per local protocol), a 7-day endophthalmitis symptom warning (sudden pain, severe redness, vision loss, floaters, photophobia), and 24/7 contact details.
• Treat-and-extend OCT decision-making — at each subsequent visit, OCT macula determines extend / treat-as-before / shorten; the aim is to reach the longest interval at which the macula remains dry and the BCVA stable.
• CQC-registered clean-room or sterile minor procedure room with the latest report rated Good or Outstanding; transparent itemised written pricing; direct telephone access to the consultant for the duration of treatment.
• Honest evidence-based consent — written information about per-injection endophthalmitis (0.02–0.05%), intra-ocular inflammation (1–2% per patient course), rare retinal vasculitis with occlusion, the treat-and-extend rationale and the realistic year-1 and maintenance-year treatment burden.

What does the evidence say about faricimab?

The faricimab evidence base is among the strongest of any modern intravitreal therapy and is consistent across indications:

• TENAYA and LUCERNE phase 3 wet AMD trials (Heier et al., Lancet 2022) — identical-design randomised non-inferiority trials of treatment-naive neovascular AMD, faricimab 6mg with treat-and-extend up to Q16 after four monthly loading doses vs aflibercept 2mg Q8 after three monthly loading doses. Primary endpoint mean BCVA change at year 1: ~+6 ETDRS letters in both arms, non-inferior. At year 2: around 60% of faricimab patients on Q12 or Q16, with maintained BCVA gains and a substantially lower treatment burden than aflibercept 2mg.
• YOSEMITE and RHINE phase 3 DMO trials (Wykoff et al., Lancet 2022) — identical-design randomised non-inferiority trials in DMO, faricimab 6mg with treat-and-extend up to Q16 vs aflibercept 2mg Q8. Non-inferior BCVA outcomes at year 1; around 50–60% of faricimab patients on Q12 or Q16 by year 2; substantial reduction in central retinal thickness.
• BALATON and COMINO phase 3 RVO trials (2024) — faricimab non-inferior to aflibercept 2mg in macular oedema secondary to BRVO and CRVO at year 1; extended dosing in a substantial proportion of patients.
• AVONELLE-X and RHONE-X open-label extension studies — sustained BCVA gains and durable treatment intervals through years 2 to 4 in wet AMD and DMO respectively.
• NICE Technology Appraisals TA800 (wet AMD) and TA799 (DMO) — both recommend faricimab as an option for treating the licensed indications, within the marketing authorisation. Subsequent NICE guidance covers macular oedema secondary to BRVO and CRVO.
• Royal College of Ophthalmologists wet AMD commissioning guidance — faricimab and aflibercept 8mg are the preferred first-line options for treatment-naive wet AMD in 2025–2026, on the basis of lower year-2 treatment burden than aflibercept 2mg, ranibizumab or bevacizumab while maintaining equivalent BCVA outcomes.
• Real-world evidence (Truckenbrod 2024, IRIS Registry 2024–2025, AAO 2024/2025) — faricimab effective in routine clinical practice with comparable BCVA outcomes to trial data and lower treatment burden; effective as a switch agent in patients unable to extend on aflibercept 2mg or ranibizumab.
• Safety — the integrated safety database across TENAYA / LUCERNE / YOSEMITE / RHINE / BALATON / COMINO shows endophthalmitis rate 0.02–0.05% per injection, intra-ocular inflammation 1–2% per patient course, and retinal vasculitis with occlusion rare and at lower frequency than brolucizumab (Beovu).
• Cost-effectiveness (NICE) — faricimab is cost-effective at NHS list price net of the confidential commercial discount, on the basis of lower year-2 treatment burden offsetting the per-injection drug cost.

In short: faricimab is one of the best-evidenced and most clinically refined intravitreal therapies for wet AMD, DMO and RVO in 2026, with strong randomised and real-world data on BCVA, treatment burden and safety, and a unique dual VEGF-A / Ang-2 mechanism that allows safe extension of the treatment interval in a meaningful proportion of patients.

Faricimab vs aflibercept, ranibizumab, brolucizumab and bevacizumab

Each modern intravitreal anti-VEGF agent has a defined 2026 indication and treatment-burden profile:

• Faricimab (Vabysmo, Roche) — 6mg bispecific VEGF-A and Ang-2 antibody; four monthly loading doses then treat-and-extend Q8 up to Q16. Lowest year-2 treatment burden among anti-VEGFs in TENAYA / LUCERNE / YOSEMITE / RHINE / BALATON / COMINO. NICE TA800 / TA799. Per injection UK 2026 £1,100–£1,650.
• Aflibercept 8mg (Eylea HD, Regeneron / Bayer) — high-dose VEGF-A plus PlGF fusion protein; three monthly loading doses then Q12 or Q16 by treat-and-extend. Comparable BCVA and treatment-burden profile to faricimab in PULSAR / PHOTON. Per injection UK 2026 £1,200–£1,750.
• Aflibercept 2mg (Eylea, Regeneron / Bayer) — VEGF-A plus PlGF fusion protein; three monthly loading doses then Q8 or treat-and-extend. Established gold standard with the largest cumulative clinical experience. Per injection UK 2026 £900–£1,400. Biosimilars in development.
• Ranibizumab (Lucentis, Novartis / Genentech) — 0.5mg VEGF-A antibody fragment; three monthly loading then PRN or treat-and-extend. Multiple biosimilars (Ongavia, Ranivisio, Byooviz). Per injection UK 2026 £850–£1,300.
• Brolucizumab (Beovu, Novartis) — 6mg single-chain antibody fragment; three monthly loading then Q8 / Q12. Highest molar dose; more compact molecule allowing higher vitreous concentration. Associated with a measurable risk of intra-ocular inflammation including retinal vasculitis with occlusion (HAWK / HARRIER post-hoc analyses); use is more selective in 2026. Per injection UK 2026 £1,000–£1,450.
• Bevacizumab (Avastin, Roche) — off-label VEGF-A antibody re-packaged from oncology vials; widely used in NHS hospital eye services on a cost-effectiveness basis where local commissioning permits. Comparable BCVA to ranibizumab in CATT and IVAN. Not licensed for intravitreal use in the UK.

The decision between faricimab, aflibercept 2mg / 8mg, ranibizumab and brolucizumab is shared with the consultant medical retinologist on the basis of the indication, the patient’s prior treatment history (treatment-naive vs switch), the anticipated treatment burden, intra-ocular inflammation risk, comorbidities, the local NHS / private commissioning landscape and patient preference. For treatment-naive wet AMD, faricimab and aflibercept 8mg are commonly first-line for the lowest year-2 burden; for switch patients unable to extend on aflibercept 2mg or ranibizumab, faricimab is a logical choice on the basis of the dual mechanism.

Who is a good candidate for faricimab?

The strongest case for faricimab applies when one or more of the following are present:

• Newly diagnosed treatment-naive neovascular (wet) AMD — with active intra-retinal fluid, sub-retinal fluid or pigment epithelial detachment on OCT macula and a confirmed neovascular complex on OCT angiography or FFA, in an eye with viable macular function.
• Diabetic macular oedema (DMO) — with central macular thickness above the NICE TA799 threshold and BCVA criteria, in a patient with controlled or controllable systemic diabetes; faricimab is licensed and NICE-approved on the basis of YOSEMITE / RHINE.
• Macular oedema secondary to branch or central retinal vein occlusion (BRVO, CRVO) — on the basis of BALATON / COMINO.
• Patients already on aflibercept 2mg, ranibizumab or bevacizumab unable to extend safely — with recurrent intra-retinal or sub-retinal fluid at intervals of Q4 to Q6 despite optimisation; real-world evidence shows 40–60% can extend safely on faricimab.
• Polypoidal choroidal vasculopathy (PCV) — faricimab is effective off-label / case-by-case in PCV, on the basis of small series and consensus statements; ICG imaging is essential.
• Motivation for the lowest possible treatment burden — for working-age patients, distant-living patients, patients with mobility limitations or those with strong preferences for fewer hospital visits per year.
• No active ocular infection, no active uveitis, no recent arterial thromboembolic event, no known hypersensitivity to faricimab.
• Ability to attend and tolerate intravitreal injection and OCT-driven follow-up.

Faricimab is not appropriate in active ocular or peri-ocular infection, active uveitis or endophthalmitis, known hypersensitivity to faricimab, pregnancy / breastfeeding (no safety data), recent arterial thromboembolic event (within 3 months) on a case-by-case basis, or where the macula is end-stage with established subretinal fibrosis or macular atrophy and no prospect of visual benefit. Suitability is always confirmed at a consultant medical retina consultation with OCT and OCT angiography.

NHS, private medical insurance and faricimab

NHS access to faricimab in the UK in 2026 is well-established. NICE Technology Appraisal TA800 recommends faricimab as an option for neovascular AMD, TA799 covers DMO, and further NICE guidance covers macular oedema secondary to BRVO and CRVO. Faricimab is commissioned via NHS England (and equivalent pathways in Scotland, Wales and Northern Ireland) and delivered through hospital eye service medical retina clinics in structured 4–16 weekly treat-and-extend pathways. Realistic NHS waits for the first injection after wet AMD diagnosis are typically 1–4 weeks in 2026; faster fast-track pathways exist for patients with high-risk presentations. NHS care is excellent and the only practical limitations are the timing of the first injection, choice of consultant and the breadth of imaging available at the local trust.

Private faricimab is the practical route when same-week initiation matters (for example, rapidly progressing wet AMD with active fluid in a fellow eye), when you want a specific consultant medical retinologist or clinic, when you have private medical insurance that covers the procedure, or when local NHS pressures mean a delayed first injection beyond a clinically acceptable window. Most CQC-registered medical retina centres can complete consultation, OCT, OCT angiography and the first faricimab injection within 5–7 days.

In 2026 the major UK private medical insurers (Bupa, AXA Health, Aviva, Vitality, WPA) cover faricimab for licensed indications when there is a documented diagnosis on OCT, OCT angiography (where appropriate) and consultant medical retina assessment. Coverage typically includes the consultant fee, OCT imaging, the injection procedure, the drug itself and immediate post-injection follow-up. Pre-authorisation in writing is required and should specify the indication, the planned schedule (four monthly loading doses then treat-and-extend) and the expected number of injections in year 1. Insurers generally do not cover faricimab for off-label indications outside the licensed scope, for screening, for end-stage disease with no realistic prospect of visual benefit, or for procedures performed outside CQC-registered premises. Our guidance for insured patients explains how to arrange cover.

Risks and side-effects of faricimab

Intravitreal faricimab is one of the safest interventional ocular procedures, but it is an intra-ocular injection of a biologic and the realistic risks should be set out honestly:

• Endophthalmitis — 0.02–0.05% per injection with povidone-iodine prep and sterile technique; a severe sight-threatening intra-ocular infection. Prevented by povidone-iodine surface preparation, sterile drape, lid speculum, no-touch technique and the 7-day post-injection symptom warning (sudden pain, severe redness, vision loss, floaters, photophobia).
• Traumatic cataract — less than 0.1% per injection; caused by inadvertent lens contact.
• Retinal detachment — less than 0.05% per injection; presents with new floaters and a curtain over the vision.
• Vitreous haemorrhage — less than 0.1% per injection; usually self-limiting.
• Subconjunctival haemorrhage — very common, cosmetic only, resolves in 1–2 weeks.
• Transient IOP spike — very common immediately post-injection, usually resolves within 30 minutes; treated with topical IOP-lowering medication if needed.
• Transient blurred vision / floaters — from the injection bubble / dispersal of the drug in the vitreous; resolves within 24–48 hours.
• Intra-ocular inflammation (IOI), drug-specific — 1–2% per patient course; usually mild anterior chamber inflammation responding to topical steroid. Rare cases of retinal vasculitis with occlusion have been reported but at lower frequency than brolucizumab (Beovu).
• Allergic / hypersensitivity reactions — rare; require discontinuation.
• Systemic anti-VEGF risks (arterial thromboembolic events) — very low with intravitreal administration because of minimal systemic exposure; an honest part of consent in patients with recent stroke or myocardial infarction.
• Treatment burden — lifelong intravitreal therapy with OCT monitoring at each visit. Most patients require 4–8 injections per year on treat-and-extend, falling over time.

The overall safety record of faricimab is excellent in experienced UK hands; the procedural risks are minimised by povidone-iodine prep, sterile technique and adherence to the 7-day post-injection symptom warning; the drug-specific intra-ocular inflammation rate is favourable; and the realistic year-1 and maintenance-year treatment burden is lower than with VEGF-A monotherapy.

After a faricimab injection and the treat-and-extend pathway

• Immediately after the injection — mild grittiness, transient blurred vision, floaters from the injection bubble. Subconjunctival haemorrhage at the injection site is common and cosmetic only. Topical antibiotic for 24–48 hours.
• First 7 days — be vigilant for endophthalmitis symptoms (sudden pain, severe redness, vision loss, floaters, photophobia); if any develop, contact the clinic urgently and be seen the same day. Otherwise, no specific posturing or activity restriction.
• Loading phase (months 1 to 4) — four monthly injections. Most patients notice a partial improvement in distortion and central vision within 1–4 weeks of the first injection, with progressive macular drying on OCT over the first 4–12 weeks.
• Treat-and-extend (month 5 onwards) — at each visit, OCT macula determines the next interval: a dry macula and stable BCVA extends the interval by 4 weeks (up to Q16 maximum); borderline / stable continues at the current interval; recurrent fluid or visual decline shortens the interval by 4 weeks (minimum Q8).
• Year 1 outcomes — mean BCVA gain ~+5 to +6 ETDRS letters from baseline; stable or improved BCVA in 80–90% of patients; mean central retinal thickness reduction ~150–200 microns from baseline.
• Year 2 and beyond — around 60% of TENAYA / LUCERNE patients on Q12 or Q16 dosing; sustained BCVA gains in the AVONELLE-X / RHONE-X extension studies through years 2 to 4.
• Long-term monitoring — OCT at every visit. A small proportion of patients (perhaps 5–10%) achieve long-lasting remission and can pause treatment with 3-monthly OCT surveillance. Stopping without monitoring is associated with a high risk of vision loss.
• If treatment fails — if faricimab does not control the disease (persistent fluid at Q4 to Q6 despite optimisation), the consultant may switch to aflibercept 8mg (Eylea HD) or aflibercept 2mg (Eylea) on a case-by-case basis.

Frequently asked questions