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S. Kotak, G. F. Schwartz, J. Tan; Hyperemia-associated Costs of Medication Changes in Glaucoma Patients Treated Initially with Prostaglandin Analogs. Invest. Ophthalmol. Vis. Sci. 2009;50(13):4088.
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Develop a model to estimate and compare hyperemia-related costs in glaucoma patients treated initially with latanoprost (LAT), bimatoprost (BIM), or travoprost (TRA) monotherapy.
Patients with a diagnosis of glaucoma who were newly treated with LAT, BIM, or TRA monotherapy were identified (HealthCore Managed Care Database). Physician-reported rates of hyperemia and physician-driven transition rates (switch or discontinuation of therapy) related to reports of hyperemia were documented from chart reviews of 300 patients from the Glaucoma Adherence and Persistency Study. The per-patient direct cost (2008) due to hyperemia-driven change in therapy was calculated as the sum of the cost of the initial prescription plus the cost of the office visit where the patient was evaluated and the decision to change therapy was made. Costs were stratified by whether patients were hyperemia free or discontinued the initial therapy due to hyperemia.
From the sample of 13,977 newly treated patients, 8743 were started on prostaglandin monotherapy only (LAT, 5726; BIM, 1633; TRA, 1384). Across all treatment groups, costs among hyperemia-free patients were $73.67 versus $140.02 for those who discontinued the initial prostaglandin due to hyperemia. Per patient costs were lowest in the group treated initially with LAT. With LAT as the reference product, total per patient incremental costs due to hyperemia-driven change in therapy were $5.92 for BIM and $5.43 for TRA. Sensitivity analyses confirmed the robustness of findings to increases either in the incidence of hyperemia among LAT-treated patients or in the cost of LAT.
Hyperemia results in increased overall costs in patients treated with LAT, BIM, and TRA. Treatment with LAT is associated with lower hyperemia-related costs than treatment with BIM or TRA.
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