Purpose:
Glaucoma patients often require multiple topical medications to reach target intraocular pressure, and treatment persistence is important. This analysis examined whether persistence differs between patients prescribed topical brimonidine/timolol or 2-bottle combinations.
Methods:
Sample patients from the Wolters Kluwer Pharma Solutions Source® Lx Database were tracked over time. Glaucoma patients (ICD-9 code 365.xx) were included if they had an index (qualifying) prescription for a product of interest from January-June 2008, but not the 6 months prior to the index prescription. Kaplan-Meier regression analysis was performed to compare medication persistence (switch or discontinue) for 12 months past the index prescription for patients receiving fixed combination of brimonidine (brim)/timolol (n=981) vs a 2-bottle combination. The 2-bottle arms were: beta blocker (BB) + brim (n=561); BB + carbonic anhydrase inhibitor (CAI; acetazolamide, metazolamide, brinzolamide, dorzolamide; n=365); BB + prostaglandin analog (PGA; bimatoprost, latanoprost, travoprost; n=1523); CAI + brim (n=483); CAI + PGA (n=922); and PGA + brim (n=1769).
Results:
From Month 3 onwards, a significantly greater proportion of patients remained on fixed combination of brim/timolol vs each of the 2-bottle combinations (Table). Further analysis of patients receiving brim/timolol showed the average number of prescriptions/patient was 7.8, and average time between prescriptions was 44.7 days, consistent with the high persistence.
Conclusions:
Persistence with topical glaucoma therapy is higher with fixed combination of brim/timolol than with 2-bottle combinations.
Keywords: intraocular pressure