MEDICAL THERAPY OF GLAUCOMA-A PHARMACO-ECONOMIC ANALYSIS

Abstract

This pharmaco-economics study was conducted to determine and compare 3- monthly and yearly cost and cost-effectiveness of various anti-glaucoma drugs; Latanoprost 0.005%, Bimatoprost 0.03%, Travoprost 0.004%, Pilocarpine 2%, Dorzolamide 2%, Brimonidine 0.2%, Timolol Maleate 0.5%. Methods: The number of drops in five new bottles were counted and then averaged for each drug. The effectiveness data was number of millilitres of IOP reduction as compared to baseline. The MRP, drop count and IOP reduction data were used to calculate the 3- monthly and the yearly cost and cost- effectiveness of the study drugs. Results: According to the study results the rank order of drugs with respect to yearly cost was Latanoprost (Rs.8840.3) >Travoprost (Rs4620.9) >Dorzolamide (Rs.3416.4) > Bimatoprost (Rs.2927.3) > Brimonidine (Rs.2379.8) > Pilocarpine (Rs.1204.5) > Timolol (Rs.423.4). The drugs in order of cost-effectiveness are timolol> pilocarpine> bimatoprost> brimonidine> travoprost> dorzolamide> latanoprost. Conclusion: On the basis of MRP, number of drops per bottle and average IOP reduction, Timolol had the most favourable cost-effectiveness amongst the study drugs. Among the Prostaglandin analogues, Bimatoprost was the most cost-effective followed by Travoprost and Latanoprost. The alfa- 2 agonist Brimonidine was found to be less cost-effective than Bimatoprost. From the cost-effectiveness point of view, Timolol should be used as first line therapy where not contraindicated and Bimatoprost followed by Brimonidine reserved as alternatives.