An economic analysis of switching to latanoprost from a beta-blocker or adding brimonidine or latanoprost to a beta-blocker in open-angle glaucoma or ocular hypertension.

BACKGROUND In treating patients with ocular hypertension or primary open-angle glaucoma, if a single agent cannot successfully control the pressure, additional medications may be prescribed. The cost of treatment may become expensive, especially with multiple drug therapy. Thus, prescribing techniques that help minimize costs may be beneficial to patients when medically appropriate. OBJECTIVE To evaluate differences in drug and visit costs after switching to latanoprost 0.005% monotherapy (LM) versus adding latanoprost 0.005% once daily (Lbeta) or brimonidine 0.2% twice daily (Bbeta) in patients uncontrolled on beta-blocker therapy alone. METHODS This study included 148 consecutive qualified charts of open-angle glaucoma or ocular hypertension patients within the first year of follow-up after switching from beta-blocker monotherapy to latanoprost or adding latanoprost or brimonidine. RESULTS The Bbeta group demonstrated the highest costs per month, followed by the Lbeta group, then the LM group. A trend existed in the Lbeta group to a lower pressure than the Bbeta or the LM groups. A greater mean change in medication per patient per month was seen in the Bbeta group compared to the latanoprost treatment groups. Additionally, a greater number of visits per month occurred in the Bbeta than in the LM and Lbeta groups. The Bbeta group also reported significantly more tearing and fatigue. CONCLUSIONS This study suggests that in patients uncontrolled on beta-blocker therapy, switching to latanoprost, when medically appropriate, may provide a further mean reduction in intraocular pressure and save costs compared to adding latanoprost or brimonidine.