Cost of glaucoma drugs may impact treatment: study

By Scott Baltic

NEW YORK (Reuters Health) - The cost of a year's worth of glaucoma medication can vary by a factor of almost 6, depending on the specific drug and the daily dosage used, and is rising steadily overall, according to a study by researchers at Texas A&M University System Health Science Center College of Medicine in Temple.

Compliance with medication "is one of the biggest challenges physicians face in regards to managing chronic disease," Dr. Steven D. Vold told Reuters Health. "Numerous studies confirm that cost ... is a significant reason why patients don't take their medications. Physicians should have a good handle on the patient costs of all medications they routinely prescribe."

In the United States, the management of glaucoma costs about $2.5 billion per year. Of the $1.9 billion in direct costs, glaucoma medications account for an estimated 38 percent to 52 percent of the total.

The current report, the third by Vold and Dr. Nathan R. Rylander since 1999, provides current information for physicians and patients on the annual cost of treating glaucoma with topical medications. It appears in the January issue of the American Journal of Ophthalmology.

Excepting Betoptic S (betaxolol, Alcon Laboratories), the least expensive glaucoma medications by category were the beta-blockers. The least expensive brand-name beta-blocker, according to the study, is Timoptic 0.5 percent (timolol maleate, Merck & Co., 10.0 mL), at $203.47 a year with twice-daily dosing. The least expensive medications overall were both generics: timolol maleate 0.5 percent (Falcon, 15.0 mL) at $150.81/year and metipranolol 0.3 percent (Falcon, 10.0 mL) at $151.96, both at twice-daily dosing.

"Yearly costs of the prostaglandin analogs ranged from $427.69 for Travatan (Alcon) to $577.62 for Lumigan (Allergan)," the researchers report.

The most expensive medication was a thrice-daily dose of Alphagan P 0.15 percent (brimonidine ophthalmic, Allergan), at $873.98.

Most medication containers were overfilled, the researchers discovered. For example, latanoprost 2.5 mL (Xalatan, Pfizer) and bimatoprost 2.5 mL (Lumigan, Allergan) were the most overfilled at 25.2 percent and 29.4 percent, respectively.

Some medications, however, were underfilled.

The average wholesale price of all medications available in 1999 and 2006 increased over that period, as did the price of most of the medications between 2002 and 2006.

The investigators note that their report covers patient costs "and does not address issues of efficacy, tolerability, or patient safety."

SOURCE: American Journal of Ophthalmology, January 2008.