First-year treatment costs among new initiators of topical prostaglandin analogs

Abstract

Jordana K Schmier1, David W Covert2, Alan L Robin3,41Exponent Inc., Alexandria, VA, USA; 2Health Economics, Alcon Research Ltd., Fort Worth, TX, USA; 3Department of Ophthalmology, University of Maryland, Baltimore, MD, USA; 4Wilmer Eye Institute, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USAObjective: To estimate first-year costs among new initiators of topical prostaglandin analogs in a managed care population.Research design and methods: We developed a model to estimate first-year direct medical costs. We derived treatment patterns from a claims database analysis. Published studies were used to estimate visit-related resource use. Costs were obtained from standard sources.Results: The database analysis identified 9,063 patients meeting study criteria, 41% (n = 3,672) of whom remained on their initial prostaglandin therapy for 12 months after initiation. Adjunctive intraocular pressure lowering therapy was needed in 20.7%, 16.5%, 13.9%, and 8.9% of bimatoprost, latanoprost, travoprost, and BAK-free travoprost patients, respectively. Median numbers of days to the first prescription filled for adjunctive therapy (if required) were 69.5, 67.0, 123.0, and 158.5 for patients initiating on bimatoprost, latanoprost, travoprost, and BAK-free travoprost. Total estimated first-year costs were $1,457, $1,360, $1,278, and $1,307 for patients initiating therapy with bimatoprost, latanoprost, travoprost, and BAK-free travoprost. Findings were consistent through sensitivity analysis.Conclusions: A BAK-free prostaglandin analog may permit longer duration of monotherapy and be associated with lower first-year direct medical costs. Use of a claims database and the selection of new initiators of prostaglandin analogs limit projecting findings to all glaucoma patients.Keywords: costs and cost analysis, drug therapy, combination, glaucoma, prostaglandin analogs