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Changes of the Types and Daily Costs of Topical Antiglaucoma Medications from 2006 to 2021 in China. J Clin Pharm Ther 2023. [DOI: 10.1155/2023/7966922] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/18/2023]
Abstract
Purpose. To investigate the changes of the types and daily costs of topical antiglaucoma medications from 2006 to 2021 in China, providing evidence for optimizing treatment regimen and medical insurance policy. Methods. The types of topical antiglaucoma drugs except complementary and traditional medicines and associated price information were collected from the largest pharmaceutical database in China (YAOZH database). The daily costs of each drug, the average income level, and the daily cost of topical antiglaucoma medications relative with daily disposable income were calculated and compared between 2006 and 2021. Results. The options of topical antiglaucoma drugs increased remarkably to 32 types in 2021, of which prostaglandin analogs comprised the largest proportion (31.25%). There were 10 types of the same brand drugs available in 2006 and 2021, the mean daily cost of which decreased from $0.39 ± 0.30 to $0.28 ± 0.23 (
). As the average daily disposable income of Chinese residents grew greatly, the proportion of the daily cost of topical antiglaucoma medications in daily disposable income in 2021 declined significantly from 32.52% to 5.78% (all the drugs,
) and 3.94% (without unit dose package,
) in rural areas and from 9.95% to 2.31% (all the drugs,
) and 1.57% (without unit dose package,
) in urban areas. Conclusions. Topical antiglaucoma medications available become much more abundant in China. With the increase of residents’ disposable income and reduction of daily costs of topical antiglaucoma medications, the drug treatment for glaucoma becomes more affordable both in rural and urban areas.
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Sun X, Yao K, Liu Q, Zhang H, Xing X, Fang A, Duan X, Yu M, Chen MY, Yang J, Goodkin ML. Safety of Fixed-Combination Bimatoprost 0.03%/Timolol 0.5% Ophthalmic Solution at 6 Months in Chinese Patients with Open-Angle Glaucoma or Ocular Hypertension. Ophthalmol Ther 2023; 12:341-353. [PMID: 36370233 PMCID: PMC9834455 DOI: 10.1007/s40123-022-00593-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2022] [Accepted: 10/06/2022] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Fixed-combination bimatoprost 0.03%/timolol 0.5% ophthalmic solution (FCBT; Ganfort®, Allergan, an AbbVie company) effectively reduces intraocular pressure (IOP) via complementary mechanisms of action of the agents, but long-term (> 12 weeks) safety evaluations of FCBT remain limited. FCBT safety is evaluated herein, with particular focus on hyperemia and eyelash growth, at 24 weeks in Chinese patients with open-angle glaucoma (OAG) or ocular hypertension (OHT). METHODS In this multicenter, open-label, noncomparative, phase 4 study conducted in China, patients diagnosed with OAG or OHT having insufficient response to β-blocker- or prostaglandin analogue/prostamide (PGA)-based IOP-lowering monotherapy in one or both eyes were switched from their current IOP-lowering treatment to FCBT (one drop per eye every evening) without prior washout. Assessment visits were scheduled at baseline and weeks 4, 12, and 24 (or study exit). The primary outcome measure was adverse event (AE) incidence through 24 weeks. RESULTS Of 725 patients enrolled, 632 (87.2%) completed the study; 93 (12.8%) patients discontinued, including 29 (4.0%) due to AEs. Of 1326 FCBT-treated eyes (total), 594 (44.8%) experienced ≥ 1 ocular treatment-related AE during the study. Conjunctival hyperemia (the most common AE overall) and eyelash growth were reported in 269 (20.3%) and 54 (4.1%) FCBT-treated eyes, respectively. The incidence of other known PGA-related AEs (including blepharal pigmentation and erythema of eyelid) was < 10% each. Most conjunctival hyperemia reports were mild in severity (214/259; 82.6%) and only 1/259 (0.4%) was severe. Similarly, most cases of eyelash growth were mild (46/52; 88.5%); none were severe. One (< 0.1%) FCBT-treated eye had a serious ocular AE (OAG) considered FCBT-related. CONCLUSIONS The frequency and severity of FCBT-related AEs, including conjunctival hyperemia and eyelash growth, are consistent with previously published findings. No new safety concerns were raised. This prospective study reaffirms that once-daily FCBT is a safe and well-tolerated therapy for OAG and OHT. CLINICALTRIALS GOV IDENTIFIER NCT02571712.
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Affiliation(s)
- Xinghuai Sun
- Eye & ENT Hospital of Fudan University, No. 83, Fenyang Road, Xuhui District, Shanghai, China.
| | - Ke Yao
- Eye Center of the Second Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
| | | | - Hong Zhang
- Tongji Hospital of Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - Xiaoli Xing
- Tianjin Medical University Eye Hospital, Tianjin, China
| | - Aiwu Fang
- Eye Hospital of Wenzhou Medical University, Wenzhou, China
| | - Xuanchu Duan
- Second Xiangya Hospital of Central South University, Changsha, China
| | - Minbin Yu
- Zhongshan Ophthalmic Center, Sun Yat-Sen University, Guangzhou, China
| | - Michelle Y Chen
- Allergan (an AbbVie Company), Irvine, CA, USA
- Perfuse Therapeutics, Inc., San Francisco, CA, USA
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Lazzaro C, van Steen C, Ghirelli G, Sacchi M, Sisto D, Uva M, Varano L, Angelillo L. A latanoprost cationic emulsion (STN1013001) vs. other latanoprost formulations (Latanoprost) in open angle glaucoma/ocular hypertension and ocular surface disease: an Italian cost-utility analysis. Expert Rev Pharmacoecon Outcomes Res 2023; 23:251-265. [PMID: 36576091 DOI: 10.1080/14737167.2023.2161515] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
BACKGROUND STN1013001 is an innovative latanoprost cationic emulsion for open-angle glaucoma/ocular hypertension (OAG/OHT) and ocular surface disease (OSD). METHODS AND FINDINGS A 5-year, 7 health states, 1-year cycle early Markov model-supported cost-utility analysis (CUA) of STN1013001 vs. other latanoprost formulations (Latanoprost) followed the Italian National Health Service (INHS) perspective.One-way, probabilistic and scenario sensitivity analyses tested the uncertainty of the baseline results. Value of information analysis (VOIA) investigated the potential cost-effectiveness of collecting further evidence. RESULTS Over 5 years, the Markov model-supported CUA predicts STN1013001 to be potentially highly cost-effective vs. Latanoprost (+€57.60 cost at €2020 values; +0.089 Quality-Adjusted Life Years).The Incremental Cost-Utility Ratio (€647.65) falls well below the lower limit of the acceptability range proposed for Italy (€25,000-€40,000).Sensitivity analyses confirmed the robustness of the baseline findings. VOIA highlighted that further information might only be cost-effective for OAG/OHT utilities and OSD-related disutility. CONCLUSION STN1013001 is potentially highly cost-effective and strongly dominant vs. Latanoprost for OAG/OHT+OSD patients from the INHS perspective. These findings should be re-assessed using the data from the ongoing Phase III trial (NCT04133311) comparing the efficacy and safety of STN1013001 vs. Latanoprost and with future real-world CUAs upon the availability of STN1013001 on the Italian market.
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Affiliation(s)
- Carlo Lazzaro
- Pharmacoeconomics and Health Economics Department, Studio di Economia Sanitaria, Milan, Italy.,School of Pharmacology, Biology and Biotechnologies Department "Lazzaro Spallanzani," University of Pavia, Pavia, Italy
| | | | - Giorgio Ghirelli
- Hospital ophthalmology unit, Italian National Health Service-endorsed hospital "San Pietro", Rome, Italy
| | - Matteo Sacchi
- University Eye Clinic, San Giuseppe Hospital, Multimedica, Milan, Italy
| | - Dario Sisto
- Academic ophthalmology unit, Azienda Ospedaliera Universitaria "Policlinico di Bari", Bari, Italy
| | - Maurizio Uva
- Academic ophthalmology unit, Azienda Ospedaliero Universitaria Policlinico "G. Rodolico - San Marco", Catania, Italy
| | - Luigi Varano
- Hospital ophthalmology unit, Private eye clinic "Villa Richeldi", Carpi, Italy
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Teus MA, Belda JI, Lavín C, GarcÃa-Feijoà J, Falvey H, Buseghin G, Soler M, Appierto M. Cost-effectiveness analysis of iStent Inject® implantation during cataract surgery compared to cataract surgery alone for mild to moderate open-angle glaucoma patients in Spain. EXPERT REVIEW OF OPHTHALMOLOGY 2021. [DOI: 10.1080/17469899.2021.1939685] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Miguel A Teus
- Ophtalmology Department, Hospital Universitario Príncipe De Asturias, University of Alcalá, Madrid, Spain
| | - Jose I Belda
- Ophthalmology Department, Hospital Universitario Torrevieja, Alicante, Spain
| | - Cosme Lavín
- Ophthalmology Department, Hospital Universitario La Paz, Madrid, Spain
| | - Julián GarcÃa-FeijoÃ
- Ophthalmology Unit, Hospital Clínico San Carlos, Instituto De Investigación Sanitaria Del Hospital Clínico San Carlos (Idissc), OFTARED, Madrid, Spain
| | - H Falvey
- Health Economics and Market Access Department, Glaukos, San Clemente, California, United States
| | - Giorgio Buseghin
- Health Economics and Market Access Department, Glaukos, San Clemente, California, United States
| | - María Soler
- Health Economics Department, Outcomes’10 S.L.U, Castellón De La Plana, Spain
| | - Marilena Appierto
- Health Economics Department, Outcomes’10 S.L.U, Castellón De La Plana, Spain
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Feldman RM, Cioffi GA, Liebmann JM, Weinreb RN. Current Knowledge and Attitudes Concerning Cost-Effectiveness in Glaucoma Pharmacotherapy: A Glaucoma Specialists Focus Group Study. Clin Ophthalmol 2020; 14:729-739. [PMID: 32184559 PMCID: PMC7064281 DOI: 10.2147/opth.s236030] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2019] [Accepted: 01/09/2020] [Indexed: 11/25/2022] Open
Abstract
Background Rising healthcare costs motivate continued cost-reduction efforts. To help lower costs associated with open-angle glaucoma (OAG), a prevalent, progressive disease with substantial direct and indirect costs, clinicians need to understand the cost-effectiveness of intraocular pressure (IOP)-lowering pharmacotherapies. There is little published information on clinicians’ knowledge and attitudes about cost-effectiveness in glaucoma treatment. Purpose This pilot focus group study aimed to explore clinician attitudes and perspectives around the costs and cost drivers of glaucoma therapy; the implementation of cost-effectiveness decisions; the clinical utility of cost-effectiveness studies; and the cost-effectiveness of available treatments. Methods Six US glaucoma specialists participated in two separate teleconferencing sessions (three participants each), managed by an independent, skilled moderator (also a glaucoma specialist) using a discussion guide. Participants reviewed recent publications (n=25) on health economics outcomes research in glaucoma prior to the sessions. Results Participants demonstrated a clear understanding of the economic burden of glaucoma therapy and identified medications, diagnostics, office visits, and treatment changes as key cost drivers. They considered cost-effectiveness an appropriate component of treatment decision-making but identified the need for additional data to inform these decisions. Participants indicated that there were only a few recent studies on health economics outcomes in glaucoma which evaluate parameters important to patient care, such as quality of life and medication adherence, and that longitudinal data were scant. In addition to efficacy, participants felt patient adherence and side-effect profile should be included in economic evaluations of glaucoma pharmacotherapy. Recently approved medications were evaluated in this context. Conclusion Clinicians deem treatment decisions based on cost-effectiveness data as clinically appropriate. Newer IOP-lowering therapies with potentially greater efficacy and favorable side-effect and adherence profiles may help optimize cost-effectiveness. Future studies should include: clinicians’ perspectives; lack of commercial bias; analysis of long-term outcomes/costs; more comprehensive parameters; real-world (including quality-of-life) data; and a robust Markov model.
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Affiliation(s)
| | - George A Cioffi
- Department of Ophthalmology, NewYork Presbyterian Hospital Columbia University Irving Medical Center, NY, New York, USA
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Tachkov K, Vassilev A, Kostova S. Modeling the Pharmacotherapy Cost and Outcomes of Primary Open-Angle Glaucoma With Dry Eye. Front Public Health 2019; 7:363. [PMID: 31921735 PMCID: PMC6934000 DOI: 10.3389/fpubh.2019.00363] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2019] [Accepted: 11/14/2019] [Indexed: 01/17/2023] Open
Abstract
We aimed to analyze and model the cost and results of current outpatient pharmacotherapy practice in patients with primary open-angle glaucoma concomitant with dry-eye disease (POAG+DE). The point of view is that of the health care system and patients, and the time horizon was 1 year. Data were collected through a prospective, observational, real-life study of therapy practice in patients admitted to the specialized ophthalmology clinic at the Alexandrovska University Hospital in Sofia. Pharmacotherapy was recorded and analyzed by therapeutic group and INN. The probability of being prescribed preservative-free or non-free formulations was calculated, as were the cost of yearly therapy, reimbursed cost, and patient co-payment. A decision tree exploring the cost-effectiveness of preservative-free and preservative non-free formulations was built. Outcomes were recorded through three tests measuring tear film stability: TMS, NIBUT Ave, and ST. TMS values below 3, ST above 10 mm, and NIBUT Ave above 14 s were considered as indicators of good disease control. A total of 140 eyes were diagnosed with POAG, of which 64 had concomitant dry-eye disease and were included in the analysis. Monotherapy was prescribed to 34: 14 on preservative-free formulations and 20 on non-free. Meanwhile, 30 eyes received combination therapy: six on preservative-free and 24 on non-free. The monotherapy product was most commonly Prostaglandin Analogs (PG−73.5%), followed by beta-blockers (BB−26.5%). No carbonic anhydrase inhibitors (Ca AA) or alpha-2 adrenergic agonists (alfa 2 AA) were prescribed as monotherapy. The majority of patients showed poor disease control according to all three measures. The incremental cost-effectiveness ratio (ICER) was 744 BGN for TMS and 131 BGN for NUBIT for each successfully controlled eye—far below three times GDP per capita. For ST, the ICER was negative, benefiting non-free formulations. Therapy of POAG+DED with preservative-free formulations is cost-effective according to the WHO threshold of three times GDP. The median costs of the two treatment modalities were similar. Current practice shows that patients experience a higher burden in terms of co-payment than do institutions such as the NHIF.
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Affiliation(s)
- Konstantin Tachkov
- Department of Organization and Economics of Pharmacy, Faculty of Pharmacy, Medical University of Sofia, Sofia, Bulgaria
| | - Anton Vassilev
- Department of Ophthalmology, Medical University of Sofia, Sofia, Bulgaria
| | - Stanislava Kostova
- Department of Ophthalmology, Medical University of Sofia, Sofia, Bulgaria
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Brown GC, Brown MM. Patient Preference-Based Comparative Effectiveness and Cost-Utility Analysis of the Prostamides for Open-Angle Glaucoma. J Ocul Pharmacol Ther 2019; 35:145-160. [DOI: 10.1089/jop.2018.0114] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Gary C. Brown
- Center for Value-Based Medicine®, Hilton Head, South Carolina
- Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
- The Eye Research Institute, Philadelphia, Pennsylvania
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
| | - Melissa M. Brown
- Center for Value-Based Medicine®, Hilton Head, South Carolina
- Wills Eye Hospital, Thomas Jefferson University, Philadelphia, Pennsylvania
- The Eye Research Institute, Philadelphia, Pennsylvania
- Department of Ophthalmology, Emory University School of Medicine, Atlanta, Georgia
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Hommer A. Role of fixed combinations in the management of open-angle glaucoma. Expert Rev Pharmacoecon Outcomes Res 2011; 11:91-9. [PMID: 21351861 DOI: 10.1586/erp.10.83] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The first-line option for lowering intraocular pressure (IOP) is a single hypotensive agent, but patients frequently require additional IOP-lowering agents to reach their target pressures. Disadvantages of this multi-therapy approach include washout effect, inconvenience and poor adherence. Fixed combinations (FCs) combine two or more hypotensive agents in a single bottle, providing a convenient once-daily therapy, which tends to improve adherence. FCs generally offer equivalent efficacy to concomitant use of the individual components, with equivalent or superior tolerability. Studies also show that FCs can be more cost effective than nonfixed combinations. In terms of optimizing IOP control, minimizing visual field deterioration, preventing visual disability and minimizing associated healthcare costs, FCs are an important component of glaucoma management.
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Affiliation(s)
- Anton Hommer
- Krankenanstalt Sanatorium Hera, Lustkandlgasse 24, A-1090 Vienna, Austria.
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Curran MP, Orman JS. Bimatoprost/timolol: a review of its use in glaucoma and ocular hypertension. Drugs Aging 2009; 26:169-84. [PMID: 19220073 DOI: 10.2165/0002512-200926020-00008] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Topically administered bimatoprost 0.03%/timolol 0.5% ophthalmic solution (bimatoprost/timolol: Ganfort) comprises the synthetic prostamide bimatoprost (structurally related to prostaglandin F2 alpha) and the beta-adrenergic receptor antagonist timolol. Bimatoprost/timolol (one drop administered in the affected eye[s] once daily in the morning or evening) is an effective and well tolerated fixed combination for lowering intra-ocular pressure (IOP) in patients with open-angle glaucoma or ocular hypertension (OHT), including individuals uncontrolled on monotherapy with a beta-adrenergic receptor antagonist or prostaglandin analogue/prostamide.
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