Thyroid Eye Disease Market By Product Type (Biologic Therapies, Corticosteroids, Immunomodulatory Therapies, Orbital Decompression Surgery, Strabismus Surgery, Eyelid Surgery); By Application (Active Moderate-to-Severe Thyroid Eye Disease, Chronic or Inactive Thyroid Eye Disease, Sight-Threatening Thyroid Eye Disease, Residual Proptosis, Diplopia and Eyelid Dysfunction); By End User (Hospitals, Specialty Ophthalmology and Endocrinology Clinics, Infusion Centres, Ambulatory Surgical Centres); By Geography, Segment Revenue Estimation, Forecast, 2026–2032

Thyroid Eye Disease Market: Biologic Competition Reshapes a Combined Drug-and-Surgery Treatment Pathway

The Global Thyroid Eye Disease Market was valued at USD 2.90 billion in 2025 and is projected to reach USD 4.81 billion by 2032, expanding at a CAGR of 7.5% during 2026–2032, according to Strategic Market Research.

 

Thyroid Eye Disease (TED) treatment is increasingly focused on therapies that target specific disease pathways. FDA-approved options include Tepezza (teprotumumab) and Lumvoa (veligrotug-vvze), while Enspryng (satralizumab) is currently under Priority Review. The development pipeline also features promising candidates such as elegrobart and lonigutamab. These emerging therapies may broaden treatment options and improve disease management for patients with TED.

 

A Small Patient Base Supports High Commercial Value

Thyroid eye disease is uncommon, and total prevalence is much larger than the number of patients who progress to specialty treatment. A population study covering Olmsted County, Minnesota, estimated an age- and sex-adjusted incidence of 5 cases per 100,000 person-years and a point prevalence of about 65 per 100,000. These figures define the broad disease pool before diagnosis, severity, treatment eligibility and reimbursement reduce the number of commercially active patients.

Demand becomes more relevant after severity is considered. A US claims analysis estimated moderate-to-severe thyroid eye disease prevalence at 20.55 to 44.13 per 100,000 people, depending on the identification method. The range shows why commercial forecasts vary: coding rules, disease definitions and insurance coverage materially change the addressable population.

National evidence from Japan provides a clearer country-level view. A nationwide claims study identified 25,383 to 38,697 adults with thyroid eye disease in fiscal 2020, depending on the case definition. About 25.6% to 27.2% of the analysed population was classified as having active disease, while 12.4% to 13.1% was considered moderate to severe. These groups align more closely with systemic treatment and specialist-procedure demand than total disease prevalence.

The patient funnel narrows further because mild or inactive cases may be monitored or managed conservatively. Other patients continue to receive corticosteroids or radiotherapy. Prior authorisation, reimbursement decisions, infusion access, safety concerns, patient preference and treatment discontinuation reduce the number who complete a targeted biologic course. The market therefore combines a limited treated population with high spending per biologic patient.

 

Branded Biologics Hold the Largest Revenue Pool

Intravenous IGF-1R biologics represent the dominant treatment segment by commercial value. Tepezza established the category after becoming the first FDA-approved therapy developed specifically for thyroid eye disease. Its US$1.903 billion in 2025 revenue represented approximately 65.6% of the total market, giving a single branded therapy a larger directly observable revenue position than the fragmented corticosteroid and surgical pathways. Its current US label covers the disease regardless of activity or duration, expanding the potential treatment pool beyond the historically emphasised active phase. The labelled course consists of eight intravenous infusions given three weeks apart.

US Medicare data show the spending intensity created by this multi-administration model. CMS recorded 1,057 fee-for-service beneficiaries, 5,784 claims and approximately US$273.5 million in allowed Tepezza spending in 2023. This equated to approximately 5.5 claims and US$258,800 in allowed spending per beneficiary, demonstrating the importance of repeated treatment events within a finite biologic course.

Actual treatment volume depends on course completion. A linked IRIS Registry and Komodo Health study found that 65% of patients initiating teprotumumab completed all eight infusions, while 35% did not complete the labelled course. The completion rate indicates that close to two-thirds of initiators generated the full course of product and administration events. The remaining share represents lost infusion volume, reduced product revenue and incomplete treatment conversion. The same study reported retreatment among 10% of patients who completed an initial course, creating a smaller recurring revenue opportunity beyond first-course demand.

Tepezza sales increased from US$1.851 billion in 2024 to US$1.903 billion in 2025, representing growth of approximately 2.8%. The increase confirms the strength of the pharmaceutical pathway, although higher net selling prices and inventory movements also contributed to reported revenue performance. Patient growth, price changes and channel effects therefore need to be separated when assessing commercial momentum.

 

Corticosteroids Retain Volume Where Biologics Face Access Barriers

Targeted biologics carry the highest visible value, but corticosteroids continue to account for meaningful treatment volume. The US pre-biologic claims baseline found oral corticosteroid use in 17.3% to 23.4% of moderate-to-severe cohorts and intravenous corticosteroid use in 18.0% to 23.8%. Any relevant medication was recorded for 29.6% to 37.4% of the analysed US cohorts, showing that a substantial share of patients remained untreated with captured systemic therapy even before targeted biologics became available.

Japanese claims data recorded oral glucocorticoid use of 13.0% to 13.4% and injectable use of 8.5% to 9.9%. The figures place corticosteroids among the largest treatment segments by patient utilisation, although their lower cost means their revenue share is considerably below that of branded biologics.

This pathway remains commercially relevant because it is established, less expensive and supported by clinical guidance for active disease. Hospitals and health systems may continue using glucocorticoids when targeted biologics are unavailable, restricted by payer criteria or considered unsuitable for a patient. The segment is more volume-driven than value-driven. Its persistence also creates a comparator against which newer therapies must demonstrate sufficient clinical and economic benefit to justify premium reimbursement.

 

Lumvoa Introduces Direct Branded Competition

Lumvoa changed the US market from a single-brand category into a competitive biologic market. Like Tepezza, it is approved for thyroid eye disease regardless of disease activity or duration, allowing it to compete for both active and longstanding cases. Its main operational distinction is a five-infusion course delivered over 12 weeks, compared with eight infusions for Tepezza. The regimen reduces the number of labelled administrations by three, or 37.5%, relative to the established Tepezza course.

The shorter course creates competition around more than efficacy. Fewer visits can reduce patient travel, benefit-verification work, infusion-chair demand and opportunities for treatment interruption. Hospitals, physician offices and infusion providers must also consider how a 37.5% reduction in administration events changes capacity and infusion-related revenue per completed course.

 

Convenience and Route of Administration Are Emerging Differentiators

The next competitive shift is likely to centre on where and how treatment is delivered. Amgen announced positive Phase III results in April 2026 for a subcutaneous version of Tepezza administered through an on-body injector. The investigational formulation produced a company-reported proptosis response of 76.7% at week 24, compared with 19.6% for placebo, a difference of 57.1 percentage points.

A successful move away from intravenous delivery could help Amgen defend Tepezza’s approximately 65.6% share of the overall 2025 market after Lumvoa’s launch. It could also redistribute revenue across the care pathway. Infusion centres may lose some administration activity, while specialty-pharmacy, device-support and home-treatment services gain importance. Payer coverage, monitoring requirements, dosing frequency and delivery economics will determine the commercial impact.

Roche and Genentech are pursuing another route through Enspryng, or satralizumab, an IL-6 receptor inhibitor. The FDA accepted the thyroid eye disease application under Priority Review in June 2026, with a decision expected by 15 October 2026. Roche is positioning the subcutaneous treatment around at-home administration, which would create a new access and convenience model if approved.

Viridian is developing subcutaneous elegrobart, while Alumis is advancing lonigutamab. These programmes increase future pressure on a market once controlled by a single targeted product. Competition is moving towards fewer administrations, home delivery, longer dosing intervals and broader eligibility across active and chronic disease.

 

Surgery Remains a Durable Procedural Market

Orbital decompression is the most commercially important named procedure within the surgical pathway because it serves patients with sight-threatening pressure, severe eye protrusion or an inadequate response to medical treatment. Strabismus surgery addresses persistent double vision, while eyelid procedures correct residual retraction, exposure and functional or appearance-related problems after the disease has stabilised.

US claims data found that 6.1% to 15.8% of moderate-to-severe cohorts received at least one captured thyroid eye disease procedure. Orbital decompression was recorded for 1.2% to 3.5% of patients, strabismus surgery for 1.4% to 2.9%, and eyelid procedures for 1.1% to 3.2%. Japanese claims data reported decompression utilisation of 0.9% to 1.1% and strabismus surgery utilisation of 0.6% to 0.8%, confirming that surgery serves a smaller but persistent share of the diagnosed population.

Targeted treatment is changing this procedural mix. A nationwide US study reported a 37% decline in orbital decompression volume after teprotumumab entered the market. This provides direct evidence that biologic adoption can reduce or delay surgery and transfer part of the treatment value from procedure providers to pharmaceutical manufacturers.

Substitution remains incomplete. A separate post-treatment study found that 25% of patients and 18% of treated orbits underwent bony decompression after teprotumumab therapy. Patients with greater residual proptosis were more likely to require surgery. The 25% post-treatment surgery rate protects a meaningful procedural opportunity for orbital and oculoplastic specialists even as average decompression volume declines.

Drug and surgical revenues also behave differently. A biologic course creates repeated product and administration events within a defined period. Surgery is episodic, specialist-dependent and can involve several staged procedures. The drug market is concentrated around branded manufacturers, while the surgical market is fragmented across hospitals, ophthalmic centres and individual orbital, oculoplastic and strabismus specialists.

 

Reimbursement Determines Market Conversion

The United States remains the leading directly observable commercial market because it combines broad regulatory labels, medical-benefit reimbursement and an established revenue base. US Tepezza sales reached US$1.758 billion in 2025, accounting for approximately 92.4% of the product’s US$1.903 billion global revenue. Non-US sales contributed about US$145 million, or 7.6%, showing that the pharmaceutical segment remained heavily concentrated in the United States before broader international reimbursement developed.

The United States is also the first country with direct branded competition between Tepezza and Lumvoa. Growth still depends on benefit verification, prior authorisation, specialist referral and access to administration sites.

International expansion creates additional demand but introduces greater reimbursement uncertainty. Tepezza received European Union marketing authorisation in June 2025 for adults with moderate-to-severe thyroid eye disease. Country-level health-technology assessments and price negotiations continue to determine actual uptake.

Germany illustrates the challenge. IQWiG’s June 2026 assessment found that added benefit was not proven for the evaluated acute and chronic groups. Canada’s Drug Agency recommended against reimbursement in April 2026, while NICE deferred its appraisal in England in March 2026. These decisions increase evidence pressure, delay funded access and strengthen payer influence over pricing.

Japan presents a different opportunity. Tepezza was approved there in September 2024 for active thyroid eye disease, and the country has national claims evidence showing 25,383 to 38,697 identified adult cases. Market conversion will depend on reimbursement execution, specialist referral and the 12.4% to 13.1% share of patients classified as moderate to severe.

 

The Treatment Pathway Is Becoming More Operationally Complex

The biologic treatment pathway requires coordination among ophthalmologists, endocrinologists, orbital specialists, payers, specialty distributors and infusion providers. The specialist initiates treatment, but payer rules often determine whether the patient enters the commercial pathway. Providers then need to secure the product, confirm benefits, schedule repeated administrations and monitor patients throughout the course.

Lumvoa’s entry adds an additional layer of operational complexity to the treatment landscape. Healthcare systems and infusion practices may need to manage two high-value biologics while balancing patient volume, inventory, reimbursement and chair capacity. Its five-infusion regimen generates three fewer administration events per completed course than Tepezza, changing both infusion scheduling requirements and overall administration intensity. A future home-administered or on-body-injector product would further shift parts of the pathway toward specialty-pharmacy distribution, training, adherence support and remote monitoring.

Surgical care remains structurally distinct from drug administration. Hospitals rely on established operating-room infrastructure and procedural workflows, while clinical differentiation is driven primarily by specialist expertise, referral networks, surgical capacity and outcomes. This keeps the procedural segment durable but less standardized and more dependent on clinical practice patterns than pharmaceutical treatment pathways.

 

Safety and Treatment Persistence Limit Realised Revenue

Clinical eligibility does not guarantee a completed biologic course. Tepezza’s label includes warnings involving infusion reactions, inflammatory bowel disease, hyperglycaemia and hearing impairment. These risks can increase monitoring requirements, narrow patient selection and contribute to discontinuation. Competing products will face similar scrutiny as real-world exposure expands.

The 35% non-completion rate reported among teprotumumab initiators is commercially important because each missed infusion reduces both product and administration revenue. Manufacturers and providers therefore have an incentive to improve patient education, benefit verification, appointment continuity and adverse-event management. With only 65% of initiators completing all eight administrations, market share will increasingly depend on how reliably a therapy moves patients from authorisation through a completed course, not only on the number of treatment starts.

 

Strategic Market Outlook

The thyroid eye disease market is projected to add USD 1.91 billion in annual revenue between 2025 and 2032 while expanding at a CAGR of 7.5%. Growth is being created through competing targeted-treatment pathways rather than through a sharp increase in underlying disease incidence. Revenue expansion will depend on identifying moderate-to-severe patients, improving referral into specialist care, obtaining reimbursement and converting treatment starts into completed courses.

Intravenous biologics remain the dominant segment, supported by Tepezza’s approximately 65.6% share of the total 2025 market. Lumvoa has begun the first direct branded challenge with a regimen containing 37.5% fewer infusions. Shorter-course and subcutaneous therapies represent the most important emerging opportunities because they can change patient convenience, infusion capacity, distribution and payer comparisons.

Orbital decompression remains the leading surgical segment within the procedural pathway, although its volume has declined by 37% following pharmaceutical substitution. Strabismus and eyelid procedures retain demand because they address residual functional and anatomical problems that medical therapy may not fully correct.

 

Thyroid Eye Disease Market Report Coverage Table

Report Attribute	Details
Forecast Period	2026 – 2032
Market Size Value in 2025	USD 2.90 Billion
Revenue Forecast in 2032	USD 4.81 Billion
Overall Growth Rate	CAGR of 7.5% (2026 – 2032)
Base Year for Estimation	2025
Historical Data	2019 – 2024
Unit	USD Million, CAGR (2026 – 2032)
Segmentation	By Product Type, By Application, By End User, By Geography
By Product Type	Biologic Therapies, Corticosteroids, Immunomodulatory Therapies, Orbital Decompression Surgery, Strabismus Surgery, Eyelid Surgery
By Application	Active Moderate-to-Severe Thyroid Eye Disease, Chronic or Inactive Thyroid Eye Disease, Sight-Threatening Thyroid Eye Disease, Residual Proptosis, Diplopia and Eyelid Dysfunction
By End User	Hospitals, Specialty Ophthalmology and Endocrinology Clinics, Infusion Centres, Ambulatory Surgical Centres
By Region	North America, Europe, Asia-Pacific, Latin America, Middle East and Africa
Country Scope	U.S., Canada, UK, Germany, France, Italy, China, Japan, South Korea, India, Brazil, Mexico, Saudi Arabia, UAE, South Africa
Market Drivers	Increasing prevalence of thyroid eye disease, rising adoption of targeted biologic therapies, growing demand for advanced ophthalmic procedures, and expansion of specialised eye-care and endocrinology services
Customization Option	Available upon request