Two-year treatment patterns and costs in glaucoma patients initiating treatment with prostaglandin analogs
Two-year treatment patterns and costs in glaucoma patients initiating treatment with prostaglandin analogs
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DOI：
10.2147/opth.s13884
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发表时间：
2010-01-01
影响因子：
2.2
通讯作者：
Covert, David W.
中科院分区：
文献类型：
--
作者：
Schmier, Jordana K.;Lau, Edmund C.;Covert, David W.
目的：通过对保险理赔数据库的回顾队列分析，确定管理护理人群中局部前列腺素类似物新发起者在两年内的治疗模式和费用。通过前列腺素指数比较单一治疗和辅助治疗的使用情况。开始辅助治疗的天数和青光眼手术的比率也被计算出来。两年期间的医疗费用(抗青光眼药物和眼科就诊)被估算。结果：分析确定5018名患者至少服用一种前列腺素类似药物(比马前列酮，n=747；拉坦前列素，n=1651；不含苯扎氯铵(BAK)的曲伏前列素，n=203)。大多数(51%-54%)有重复处方。在重复用药的患者中，52%为女性(无统计学意义)，平均年龄为(P<；0.01)。不同组间的辅助治疗使用率不同(比马前列酮51%，拉坦前列素37%，不含BAK的曲伏前列素35%，P<；0.0001)。开始辅助治疗的中位天数和平均天数比马前列素组分别为83天和140天，拉坦前列素组分别为101天和181天，不含BAK的曲伏前列素组分别为113天和221天。开始使用比马前列酮、拉坦前列素和不含BAK的曲伏前列素治疗的患者的两年医疗费用分别为3147美元、2843美元和2557美元。在两年的时间里，治疗组的青光眼手术的使用情况是相似的。结论：在两年的时间里，辅助治疗的使用率和开始使用的时间以及医疗费用因前列腺素指数的不同而不同。然而，青光眼手术干预的比率在不同的指标性药物之间没有显著差异。
Objective: To determine treatment patterns and costs over a two-year period among new initiators of topical prostaglandin analogs in a managed care population by retrospective cohort analysis of an insurance claims database.Methods: Patients who initiated therapy with a prostaglandin analog between September 2006 and March 2007 were identified. The use of monotherapy and adjunctive therapies were compared by index prostaglandin. Days to initiation of adjunctive therapy and rates of glaucoma surgical procedures were also calculated. Medical costs (antiglaucoma medications and ophthalmic visits) over the two-year period were estimated.Results: The analysis identified 5018 patients with at least one prostaglandin analog prescription (bimatoprost, n = 747; latanoprost, n = 1651; benzalkonium chloride (BAK)-free travoprost, n = 203). The majority (51%-54%) had repeat prescriptions. Among those with repeat prescriptions, 52% were female (not significant) and mean age was 64 years (P < 0.01). Rates of adjunctive therapy use varied across groups (bimatoprost 51%, latanoprost 37%, and BAK-free travoprost 35%, P < 0.0001). Median and mean days to initiation of adjunctive therapy were 83 and 140 for bimatoprost, 101 and 181 for latanoprost, and 113 and 221 for BAK-free travoprost. Two-year medical costs were $3147, $2843, and $2557 for patients initiating treatment with bimatoprost, latanoprost, and BAK-free travoprost, respectively. Use of glaucoma surgical procedures across the treatment groups was similar over the two-year period.Conclusions: Over a two-year period, the rate and time to initiation of adjunctive therapy use, as well as medical costs, varied between index prostaglandins. However, the rate of glaucoma surgical interventions did not vary significantly across index medications.