Pharmacoeconomic aspects of glaucoma therapy with prostaglandin analogues in patients with signs of ocular surface disease

Treatment of glaucoma is prevalent in modern healthcare. The standard of care at this time in the majority of glaucoma patients is to be treated with prostaglandin analogues. The aim of the present study was to compare the cost-effectiveness and the effect on the daily quality of life of preservative-free tafluprost to benzalkonium chloride (BAK) preserved latanoprost ophthalmic solutions which are present on the Russian market. In the patients with signs of ocular surface disease. Material and methods. The cost calculation was carried out on the basis of the weighted average retail price in Moscow from March 2015. The research was carried out over a 1 yeartime period. At the assessment, we assumed that clinical efficacy of the compared drugs did not differ; but at the same time the absence of the negative impact of treatment on patients’ quality of life (QoL), assessed by COMTol questionnaire, was observed in 30 % of patients treated with BAK-preserved latanoprost and in 52 % of patients treated with preservative-free tafluprost. Results and discussion. The costs of glaucoma treatment with preservative-free tafluprost and with branded BAK-preserved latanoprost are now comparable. The cost per 1 patient without the negative impact of treatment on patients’ QoL for tafluprost (Taflotan®) was 42.6 % lower than that for branded latanoprost (Xalatan®), 72.7 % higher than that for the generic latanoprost Glaumax®, and 24.3 % higher than that for the generic latanoprost Latanomol™. The analysis of the results’ sensitivity to changes in the cost of drugs in real limits demonstrated their high reliability. When taking a decision on the reimbursement for prostaglandin analogues, one should be aware that generic latanoprost ophthalmic solutions may differ significantly from the branded drug both in physical and chemical properties as well as in clinical efficacy and safety. Conclusion. Preservative-free tafluprost and branded BAK-preserved latanoprost are characterized by comparable clinical efficacy whereas preservative-free tafluprost has better tolerability. At a comparable cost of treatment, preservative-free tafluprost has a higher cost-effectiveness. This allows recommending its inclusion in regional and federal programs for the treatment of glaucoma in patients with ocular surface disease signs.

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Ocular Surface Disease and Quality of Life in Patients With Glaucoma

American Journal of Ophthalmology ◽

10.1016/j.ajo.2011.05.033 ◽

2012 ◽

Vol 153 (1) ◽

pp. 1-9.e2 ◽

Cited By ~ 83

Author(s):

Simon E. Skalicky ◽

Ivan Goldberg ◽

Peter McCluskey

Keyword(s):

Quality Of Life ◽

Ocular Surface ◽

Ocular Surface Disease

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Profilo farmacologico clinico e farmacoeconomico di un gel oftalmico a base di carbomero 974P e PVA (Siccafluid®) nella terapia della cheratocongiuntivite secca

Farmeconomia Health economics and therapeutic pathways ◽

10.7175/fe.v6i3.834 ◽

2005 ◽

Vol 6 (3) ◽

pp. 185-196

Author(s):

Lorenzo Pradelli ◽

Letizia Vacchini

Keyword(s):

Quality Of Life ◽

Dry Eye ◽

Ocular Surface ◽

Tear Film ◽

Dry Eye Syndrome ◽

Lubricating Film ◽

Tear Production ◽

Ocular Discomfort ◽

Ophthalmic Solutions

BACKGROUND: The dry eye sindrome refers to a group of disorders of the tear film due to reduced tear production or excessive tear evaporation that is associated with symptoms of ocular discomfort and may cause disease of the ocular surface. Dry eye syndrome varies in severity, duration and etiology. The cornerstone of dry eye syndrome therapies includes the intraocular gel or ophthalmic solutions instillation, reaching correct artificial lubrication. Molecules that can produce a stable lubricating film are the carbomers. METHODS: In the first step of our work we reviewed the data from literature reporting about carbomers’ characteristics in respect to other lacrimal substitutes. Then, a pharmacoeconomical analysis has been performed on ophtalmic gels derived from carbomers 974P and PVA. RESULTS: Dry eye sindrome, if not adequately treated, determines a deterioration of the patient’s quality of life, other than high secondary costs. CONCLUSION: The high therapeutical index of carbomers 974P and PVA-based gels, in addition to the their limited cost (totally free for Sjögren patients in Italy), suggests that this product is characterized by one of the best benefits-to-costs ratios in the treatment of dry eye sindrome.

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How to Diagnose the Ocular Surface Disease in Treated Glaucoma Patients

European Ophthalmic Review ◽

10.17925/eor.2011.05.01.38 ◽

2011 ◽

Vol 05 (01) ◽

pp. 38 ◽

Cited By ~ 1

Author(s):

Gemma Caterina Maria Rossi ◽

Keyword(s):

Quality Of Life ◽

Intraocular Pressure ◽

Clinical Practice ◽

Early Treatment ◽

Ocular Surface ◽

Daily Clinical Practice ◽

Ocular Surface Disease ◽

Topical Drugs ◽

Chronic Use

Glaucoma is a disease usually treated with topical drugs, but the chronic use of preserved intraocular pressure (IOP)-lowering medications is associated with some symptoms of ocular surface toxicity. The ocular surface status should be evaluated regularly in glaucoma patients to ensure the detection and early treatment of pathological signs that might alter patients quality of life. The author suggests a possible sequence of evaluations to examine symptoms (adopting vision-specific quality-of-life questionnaires) and signs (using low methodologies to analyse the ocular surface status) that can be easily performed in daily clinical practice.

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AB0665 Usefulness of the ocular surface disease index (OSDI) in the assessment of vision-targeted health related quality of life (VT-HRQ) in patients with primary sjÖgren’s syndrome

Annals of the Rheumatic Diseases ◽

10.1136/annrheumdis-2012-eular.665 ◽

2013 ◽

Vol 71 (Suppl 3) ◽

pp. 676.15-676

Author(s):

F. Ferro ◽

C. Baldini ◽

G. Gabbriellini ◽

P. Pepe ◽

V. Varanini ◽

...

Keyword(s):

Quality Of Life ◽

Ocular Surface ◽

Primary Sjögren’S Syndrome ◽

Disease Index ◽

Ocular Surface Disease ◽

Health Related Quality ◽

Ocular Surface Disease Index ◽

Related Quality ◽

Health Related

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How Ocular Surface Disease Impacts the Glaucoma Treatment Outcome

BioMed Research International ◽

10.1155/2013/696328 ◽

2013 ◽

Vol 2013 ◽

pp. 1-7 ◽

Cited By ~ 16

Author(s):

Snježana Kaštelan ◽

Martina Tomić ◽

Kata Metež Soldo ◽

Jasminka Salopek-Rabatić

Keyword(s):

Ocular Surface ◽

Microbial Contamination ◽

Standard Form ◽

Ocular Surface Disease ◽

Treatment Goals ◽

Corneal Epithelial ◽

Glaucoma Treatment ◽

Preservative Free

The treatment goals for glaucoma are lowering the intraocular pressure and preservation of vision. Topical hypotensive drops are the standard form of therapy which is often associated with some symptoms of toxicity, ocular inflammation, allergy, or ocular surface disease (OSD). OSD is a common comorbidity in glaucoma patients, and its prevalence with glaucoma increases with age. Use of topical treatment could additionally increase symptoms of OSD mostly due to preservatives added to multidose medication bottles used to reduce the risk of microbial contamination. This toxicity has been particularly associated with BAK, the most commonly used preservative which damages conjunctival and corneal epithelial cells and significantly aggravates OSD symptoms. OSD adversely affects patients’ quality of life causing discomfort and problems with vision which in turn may result in noncompliance, lack of adherence, and eventually visual impairment. In the management of glaucoma patients OSD symptoms should not be overlooked. If they are present, topical glaucoma treatment should be adapted by decreasing the amount of drops instilled daily, using BAK-free or preservative-free medication and lubricants if necessary. Awareness of the presence and importance of OSD will in turn improve patients' adherence and compliance and thus ultimately the preservation of long-term vision.

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Ocular Surface Disease and Quality of Life in Patients With Glaucoma

American Journal of Ophthalmology ◽

10.1016/j.ajo.2012.01.017 ◽

2012 ◽

Vol 153 (5) ◽

pp. 1003 ◽

Cited By ~ 1

Author(s):

Halit Oguz

Keyword(s):

Quality Of Life ◽

Ocular Surface ◽

Ocular Surface Disease

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Effect of changing from preserved prostaglandins to preservative-free tafluprost in patients with glaucoma on tear film thickness

European Journal of Ophthalmology ◽

10.1177/1120672117753703 ◽

2018 ◽

Vol 28 (4) ◽

pp. 385-392 ◽

Cited By ~ 6

Author(s):

Anton Hommer ◽

Doreen Schmidl ◽

Martina Kromus ◽

Ahmed M Bata ◽

Klemens Fondi ◽

...

Keyword(s):

Quality Of Life ◽

Film Thickness ◽

Dry Eye ◽

Ocular Surface ◽

Tear Film ◽

Eye Drops ◽

Life Score ◽

Related Quality ◽

Preservative Free

Purpose: Long-term glaucoma therapy with preservative-containing eye drops may impact ocular surface health. This study was performed to investigate whether a switch from preserved topical prostaglandin therapy to preservative-free tafluprost therapy improves precorneal tear film thickness in patients with glaucoma or ocular hypertension. Methods: A total of 30 patients who were under topical preservative-containing prostaglandin monotherapy for at least 6 months were included. Patients were then switched from preserved prostaglandin therapy to unpreserved tafluprost drops once daily. Tear film thickness was measured at baseline and 4 and 12 weeks after therapy change with an ultrahigh-resolution optical coherence tomography system. Furthermore, clinical measures of ocular surface disease were determined and symptoms were assessed using the Dry Eye–Related Quality-of-Life Score. Results: After switching to unpreserved tafluprost, tear film thickness significantly increased from 4.7 ± 0.5 to 5.0 ± 0.6 µm 4 weeks after therapy change and still tended to be increased after 12 weeks (4.8 ± 0.7 µm). Breakup time significantly increased from 5.1 ± 2.3 to 7.2 ± 3.4 s and to 10.1 ± 3.6 s after therapy change. In addition, a significant decrease in corneal staining score from 1.8 ± 0.7 to 1.4 ± 0.8 after 4 weeks and to 0.7 ± 0.7 after 12 weeks treatment was observed. Switching to preservative-free drops reduced Dry Eye–Related Quality-of-Life Score from 11.4 ± 11.0 to 5.7 ± 6.4 and to 4.7 ± 7.5. Conclusion: Our data show that switching to preservative-free tafluprost leads to an increase in tear film thickness, breakup time, and an improvement of Dry Eye–Related Quality-of-Life Score. Our results therefore indicate that a switch to unpreserved tafluprost is beneficial for ocular surface health in patients under long-term preserved prostaglandin eye drops.

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