Impact of the introduction of generic latanoprost on glaucoma medication adherence.
Impact of the introduction of generic latanoprost on glaucoma medication adherence.
复制标题
引入仿制药拉坦前列素对青光眼药物依从性的影响。
DOI：
10.1016/j.ophtha.2014.11.022
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发表时间：
2015
期刊：
影响因子：
13.7
通讯作者：
Balkrishnan,Rajesh
中科院分区：
文献类型：
--
作者：
Stein,JoshuaD;Shekhawat,Nakul;Talwar,Nidhi;Balkrishnan,Rajesh
目的评估在首次引入非专利前列腺素类似物（PGA）后，开角型青光眼（OAG）患者对PGA方案的药物依从性可能发生的变化。设计纵向队列分析。2012年使用PGA的患者。方法计算引入仿制药拉坦前列素之前18个月内局部使用PGA的平均依从率（2009年9月至2011年2月）和拉坦前列素仿制药上市后18个月（2011年7月至2012年12月）。比较了在拉坦前列素仿制药上市后继续使用品牌PGA的患者与改用拉坦前列素仿制药的患者之间的发生率。多变量logistic回归分析确定了与依从性改善或恶化相关的变量≥25%.Main Outcome Measures平均依从率和25%或更高的依从性改善或恶化几率（95%置信区间[CI]）.ResultsA共有8427例患者符合研究资格标准。与转换为拉坦前列素仿制药的患者相比，继续服用商品名PGA的患者依从性改善的可能性降低28%（比值比[OR]，0.72; 95% CI，0.55-0.94），依从性降低≥ 25%的可能性增加39%（OR，1.39; 1.04-1.86）。引入仿制药后依从性的改善也与仿制药前阶段每月药物共付额较高（P= 0.02）、引入仿制药后每月药物共付额较低（P< 0.0001）和黑人种族相关（OR，1.25; 95%CI，1.04-1.50）。六百一十二例（7.3%）停止所有抗青光眼干预时，通用latanoprost成为available.ConclusionsGiven的成本可以显着阻止adherence，切换患者的通用药物可能有助于提高患者的药物治疗方案的依从性。当拉坦前列素仿制药上市时，相当多的患者完全停止了青光眼药物的使用。眼科医生应与保险公司和药剂师合作，以防止这种停止使用的通用形式的其他PGA代理商成为可用。
PurposeTo assess possible changes in medication adherence to prostaglandin analog (PGA) regimens among patients with open-angle glaucoma (OAG) after the initial introduction of generic PGAs.DesignLongitudinal cohort analysis.ParticipantsPatients older than 40 years with OAG continuously enrolled in a nationwide managed-care network during 2009–2012 who used PGAs.MethodsMean adherence rates were calculated for topical PGA use during the 18 months before the introduction of generic latanoprost (September 2009–February 2011) and the 18 months after generic latanoprost became available (July 2011–December 2012). The rates were compared between persons who continued to use brand-name PGAs once generic latanoprost became available and others who switched to generic latanoprost. Multivariable logistic regression identified variables associated with an improvement or worsening of adherence of ≥25%.Main Outcome MeasuresMean adherence rates and odds of 25% or more improved or worsened adherence (with 95% confidence intervals [CIs]).ResultsA total of 8427 patients met the study eligibility criteria. Compared with persons switching to generic latanoprost, patients who continued taking brand name PGAs were 28% less likely to have improved adherence (odds ratio [OR], 0.72; 95% CI, 0.55–0.94) and 39% more likely to have reduced adherence (OR, 1.39; 1.04–1.86) of ≥25%. Improved adherence after the generic drug's introduction was also associated with higher monthly medication copay in the pregeneric period (P= 0.02), lower copay after introduction of the generic drug (P< 0.0001), and black race (OR, 1.25; 95% CI, 1.04–1.50). Six-hundred twelve patients (7.3%) discontinued all antiglaucoma interventions when generic latanoprost became available.ConclusionsGiven that cost can significantly deter adherence, switching patients to generic medications may help improve patients' drug-regimen adherence. A considerable number of patients discontinued glaucoma drug use altogether when generic latanoprost became available. Ophthalmologists should work with insurers and pharmacists to prevent such discontinuation of use as generic forms of other PGA agents become available.
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影响因子：
4.4
作者：
J. Stein;B. Vanderbeek;Nidhi Talwar;B. Nan;D. Musch;D. Zacks
通讯作者：
J. Stein;B. Vanderbeek;Nidhi Talwar;B. Nan;D. Musch;D. Zacks
影响因子：
2
作者：
Digiuni, Maurizio;Manni, Gianluca;Rossetti, Luca
通讯作者：
Rossetti, Luca
老年人药物依从性的预测因素。
影响因子：
3.2
作者：
R. Balkrishnan
通讯作者：
R. Balkrishnan
影响因子：
13.7
作者：
Tsai, James C.
通讯作者：
Tsai, James C.
DOI：
10.1016/j.amjopharm.2009.04.001
发表时间：
2009-04-01
期刊：
AMERICAN JOURNAL OF GERIATRIC PHARMACOTHERAPY
影响因子：
--
作者：
Sleath, Betsy;Ballinger, Rex;Tudor, Gail
通讯作者：
Tudor, Gail