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J.T. Mucciolo; Cost Savings in the Lipid Class of Anti–Glaucoma Medicatoins: Looking at them from a New Angle . Invest. Ophthalmol. Vis. Sci. 2004;45(13):5558.
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© ARVO (1962-2015); The Authors (2016-present)
Introduction: Cost of glaucoma medications has become an increasing concern for patients, third party payers, and the U.S. government. The lipid class of these medications are among the most commonly prescribed drugs for the treatment of glaucoma. This study was conducted to 1) determine whether altering the angle of the bottle upon instillation increases the overall number of drops dispensed, and if so, 2) to determine which angle is best for each medication.. Methods: Three bottles each of Lumigan, Xalatan, and Travatan were held at 3 different angles to determine the number of drops dispensed to fill a 2.5 ml test tube. The bottles were placed upright after each drop was instilled. The angles measured were: 1) Almost level (10° tip down), 2) forty–five degrees (45° down), and 3) straight down (90°). Results: The mean number of drops dispensed at 10o, 45o, and 90o respectively were: Lumigan: 83,80,77; Xalatan: 67, 75, 78; and Travatan: 99,90,83. The percent increase in the number of drops dispensed for each drug when instilled at the optimal angle compared to the worst angle was: Lumigan: 8%, Xalatan: 16%, Travatan: 19%. Discussion: Total reported direct pharmaceutical sales (which does not include e.g. VA, Kaiser, etc.) for the U.S. for the past 12 months in millions were: Xalatan $339, Lumigan $112, and Travatan $59. If Xalatan drops were instilled at a 90o angle, Lumigan at a 10o angle, and Travatan at a 10o angle, there could be a potential savings of the following dollar amounts spent on each drug: Xalatan: $54 million, Lumigan: $9 million, Travatan: $11 million. Conclusion: There could be a potential immediate overall reduction in the cost of this class of medications of approximately $74 million annually in the US if the drops simply could be instilled with the bottles held at their optimal angles.
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