IngentaConnect Costs and effectiveness of travoprost versus a dorzolamide + timo...

Abstract:

Objective: To compare the effectiveness and associated costs of travoprost versus a fixed combination of dorzolamide + timolol as first-line therapy for glaucoma according to data collected by the United Kingdom General Practitioner Research Database (UK-GPRD).

Methods: Patients with a diagnosis of ocular hypertension, glaucoma, or who had been treated topically by surgery or laser therapy were selected. Patients starting first-line treatment with travoprost or a fixed dorzolamide + timolol combination were included. Times to treatment failure were compared with an adjusted Cox model.

Main outcome measures: Cost and treatment failure defined as a prescription change (adding or removing a topical treatment, or initiating laser therapy or surgery).

Results: 56 612 patients were extracted from the database and 39 808 patients received at least one topical prescription for IOP-lowering (intraocular pressure) therapy. Of these, 639 were treated with travoprost and 387 with dorzolamide + timolol, as first-line therapies. No significant difference was found between patient characteristics. Patients were aged 70.0 years and 48.5% were male. At 1 year, treatment failure was experienced by 30.4% of patients receiving travoprost and 49.4% receiving dorzolamide + timolol (p < 0.001). The hazard ratio for failure was 0.79 (p < 0.03) less with travoprost, after adjusting on age, gender, comorbidities and duration of follow-up. Adjusted annual costs of glaucoma management were significantly (p < 0.001) lower with travoprost (£198.31) than with dorzolamide + timolol (£312.21).

Conclusion: This retrospective costs and consequences analysis study showed that travoprost is more efficient than dorzolamide + timolol as first-line therapy for glaucoma patients. Patients continued longer with first-line treatment when prescribed travoprost at a lower cost.

Keywords: COSTS; ECONOMICS; EFFECTIVENESS; GLAUCOMA; TIMOLOL DORZOLAMIDE; TRAVOPROST; UK-GPRD

Document Type: Research article

DOI: 10.1185/030079907X242836

Affiliations: 1: Cemka, Bourg-la-Reine, France 2: Alcon France, Rueil-Malmaison, France

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Costs and effectiveness of travoprost versus a dorzolamide + timolol fixed combination in first-line treatment of glaucoma: analysis conducted on the United Kingdom General Practitioner Research Database