advertisement
Abstract #21468 Published in IGR 10-3
Costs and persistence of carbonic anhydrase inhibitor versus α-2 agonists, associated with β-blockers, in glaucoma and ocular hypertension: An analysis of the UK-GPRD database
Lafuma A; Berdeaux GCurrent Medical Research and Opinion 2008; 24: 1519-1527
OBJECTIVE: To compare the effectiveness and associated costs of carbonic anhydrase inhibitors + β-blocker versus α-2 adrenergic agonists + β-blocker in glaucoma therapy, as documented by The United Kingdom General Practitioner Research Database (UK-GPRD). Research Design: Patient chart analysis. METHODS: Patient records were screened for diagnoses of ocular hypertension or glaucoma, and for surgery, laser therapy or medication specific to glaucoma. Selected patients were those prescribed either carbonic anhydrase inhibitors + β-blocker or α-2 adrenergic agonists + β-blocker. Treatment failure was defined as a glaucoma prescription change, i.e. addition, cessation or replacement of medication, surgery or laser therapy. Times to treatment failure were compared with an adjusted Cox model. Main outcome measures: Treatment persistence and cost. RESULTS: Included patients were those treated with either carbonic anhydrase inhibitors + β-blocker (n = 5581) or α-2 adrenergic agonists + β-blocker (n = 1164). The average age at diagnosis was 68.1 years and 48.2% were male. Treatment failure at one year was significantly (p < 0.001) less frequent after carbonic anhydrase inhibitors + β-blocker (57% of patients) than after α-2 adrenergic agonists + β-blocker (64.3%). The hazard ratio for failure was lower (0.82: p < 0.0001) with carbonic anhydrase inhibitors + β-blocker following adjustment for age, gender, comorbidities and duration of follow-up. Adjusted annual costs of glaucoma management were £ 348.04 for carbonic anhydrase inhibitors + β-blocker and £ 356.80 for α-2 adrenergic agonists + β-blocker. CONCLUSIONS: According to UK-GPRD information, glaucoma therapy with carbonic anhydrase inhibitors + β-blocker is more persistent than with α-2 adrenergic agonists + β-blocker at a similar cost.
Dr. G. Berdeaux, Alcon France, 4, Rue Henri Sainte-Claire Deville, F-92563 Rueil-Malmaison Cedex, France. Gilles.berdeaux@alconlabs.com
Classification:
11.13.2 Betablocker and carbon anhydrase inhibitor (Part of: 11 Medical treatment > 11.13 Combination therapy)
11.13.3 Betablocker and brimonidine (Part of: 11 Medical treatment > 11.13 Combination therapy)
14 Costing studies; pharmacoeconomics
