Costs and persistence of alpha-2 adrenergic agonists versus carbonic anhydrase inhibitors, both associated with prostaglandin analogues, for glaucoma as recorded by The United Kingdom General Practitioner Research Database

• Main Authors: Philippe Denis, Antoine Lafuma, Gilles Berdeaux
• Format: Article
• Language: English
• Published: Dove Medical Press 2008-06-01
• Series: Clinical Ophthalmology
• Online Access: http://www.dovepress.com/costs-and-persistence-of-alpha-2-adrenergic-agonists-versus-carbonic-a-a1787

Philippe Denis1, Antoine Lafuma2, Gilles Berdeaux31Hôpital Edouard Herriot, Lyon, France; 2Cemka, Bourg-la-Reine, France; 3Alcon France, Rueil-Malmaison, FranceAbstract: The persistence and costs of carbonic anhydrase inhibitors + prostaglandin analogues (CAIs + PGAs) vs alpha-2 adrenergic agonists + prostaglandin analogues (alpha-2 agonists + PGAs) were compared, based on The United Kingdom General Practitioner Research Database. Patients with a diagnosis of ocular hypertension, glaucoma, or treated for this, were selected. Selected patients were prescribed CAIs + PGAs or alpha-2 agonists + PGAs. Treatment failure was defined as a prescription change (adding, removing, or replacing glaucoma treatment, or initiating laser or surgery). Times to treatment failure were compared with a Cox model adjusted by a propensity score. Mean patient age was 69.0 years and 47.6% were males. Treatment failure at 1 year was experienced by 58.8% receiving CAIs + PGAs and 66.0% of patients receiving alpha-2 agonists + PGAs (p < 0.001). The hazard ratio for failure was 0.82 (p < 0.001) in favor of CAIs + PGAs after adjusting on age, gender, comorbidities, and duration of follow-up. Adjusted annual costs of glaucoma management did not differ significantly between treatments, £440.63 with alpha-2 agonists + PGAs and £413.37 with CAIs + PGAs. CAIs + PGAs therapies appear more persistent than alpha-2 agonist + PGA in everyday clinical practice, at a similar cost.Keywords: glaucoma, alpha-2 adrenergic agonists, carbonic anhydrase inhibitor, prostaglandin, effectiveness economics, costs