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J.G. Walt, J.R. Spalding, L. Habib; Cost-Effectiveness of Bimatoprost Versus Latanoprost Plus Adjunctive Products for Glaucoma Treatment . Invest. Ophthalmol. Vis. Sci. 2003;44(13):3420.
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Purpose: Prostamides have recently been introduced to treat glaucoma patients. We evaluated the effectiveness and pharmacoeconomic impact of these newer medications in treating patients with glaucoma. We compared effectiveness and costs of bimatoprost monotherapy versus latanoprost used with adjunctive therapies. Methods: A pharmacoeconomic model was constructed based on a two-month naturalistic effectiveness trial comparing bimatoprost 0.03% (AWP of $53.13) in patients switched from all possible combination therapies with latanoprost 0.005% (AWP weighted total average cost of $43.85). The trial evaluated the percent of patients achieving target intraocular pressures (IOPs). The cost of treatment to achieve the target was calculated as medication cost divided by effectiveness based on patients achieving a target IOP of ≤ 17 mm Hg. This target was chosen based on the Advanced Glaucoma Intervention Study (AIGS) which indicated patients whose pressures were below 18 mm Hg did not progress over a six-year period. The cost-effectiveness calculation was based on cost and efficacy data during the two-month study period. Results: With bimatoprost, 59% of patients reached and maintained a target IOP of ≤ 17 mm vs. 30% with latanoprost plus adjunctive medicines (p<0.05). Common adjunctive medicines used were beta blockers (44%), alpha-agonists (27%), CAIs (15%), Cosopt (9%), and others (5%). The two-month cost-effectiveness ratio was $278 vs. $724 per successfully treated patient for bimatoprost vs. the latanoprost plus adjunctive treatments, respectively. The monthly incremental cost-effectiveness ratio per additional treatment success per month with latanoprost was $90. Conclusions: Due to a greater percentage of glaucoma patients achieving a target treatment of ≤ 17 mm Hg (considered effectiveness) with bimatoprost, bimatoprost has a more favorable cost-effectiveness profile than a combination of latanoprost plus adjunctive treatments.
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