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Abstract #20531 Published in IGR 10-1
Costs and effectiveness of travoprost versus a dorzolamide + timolol fixed combination in first-line treatment of glaucoma: Analysis conducted on the United Kingdom General Practitioner Research Database
Lafuma A; Berdeaux GCurrent Medical Research and Opinion 2007; 23: 3009-3016
OBJECTIVE: To compare the effectiveness and associated costs of travoprost versus a fixed combination of dorzolamide + timolol as first-line therapy for glaucoma according to data collected by the United Kingdom General Practitioner Research Database (UK-GPRD). METHODS: Patients with a diagnosis of ocular hypertension, glaucoma, or who had been treated topically by surgery or laser therapy were selected. Patients starting first-line treatment with travoprost or a fixed dorzolamide + timolol combination were included. Times to treatment failure were compared with an adjusted Cox model. Main outcome measures: Cost and treatment failure defined as a prescription change (adding or removing a topical treatment, or initiating laser therapy or surgery). RESULTS: 56 612 patients were extracted from the database and 39 808 patients received at least one topical prescription for IOP-lowering (intraocular pressure) therapy. Of these, 639 were treated with travoprost and 387 with dorzolamide + timolol, as first-line therapies. No significant difference was found between patient characteristics. Patients were aged 70.0 years and 48.5% were male. At 1 year, treatment failure was experienced by 30.4% of patients receiving travoprost and 49.4% receiving dorzolamide + timolol (p < 0.001). The hazard ratio for failure was 0.79 (p < 0.03) less with travoprost, after adjusting on age, gender, comorbidities and duration of follow-up. Adjusted annual costs of glaucoma management were significantly (p < 0.001) lower with travoprost (£198.31) than with dorzolamide + timolol (£312.21). CONCLUSION: This retrospective costs and consequences analysis study showed that travoprost is more efficient than dorzolamide + timolol as first-line therapy for glaucoma patients. Patients continued longer with first-line treatment when prescribed travoprost at a lower cost.
Dr. G. Berdeaux, Alcon France, 4, Rue Henri Sainte-Claire Deville, F-92563 Rueil-Malmaison Cedex, France. Gilles.berdeaux@alconlabs.com
Classification:
14 Costing studies; pharmacoeconomics
11.4 Prostaglandins (Part of: 11 Medical treatment)
11.13.2 Betablocker and carbon anhydrase inhibitor (Part of: 11 Medical treatment > 11.13 Combination therapy)