Patient peritency with topical ocular hypotenive therapy in a managed care population

Purpoe To evaluate peritency with topical ocular hypotenive therapie in patient new to pharmacological management of elevated intraocular preure (IOP). Deign Retropective, cohort tudy; Protocare cience managed care databae; approximately 3 million member in commercial health maintenance organization and preferred provider organization and in Medicare rik plan. Method Patient were at leat 20 year of age initiating therapy between July 1, 1996, and June 30, 2002, with betaxolol, bimatoprot, brimonidine, dorzolamide, latanoprot, timolol, or travoprot a monotherapy. Patient mut have been continuouly enrolled and not have received glaucoma urgery in the 180 day before the index precription fill. Precription refill record for all ocular hypotenive drug were extracted through June 30, 2002. Outcome meaure were (1) dicontinuation of index drug, and (2) either dicontinuation or change in index drug. Changing therapy wa defined a witching to or adding another ocular hypotenive. Rate of dicontinuation and dicontinuation/change were compared uing Cox regreion model. Reult In all, 28,741 patient met the incluion criteria. Compared with latanoprot, thoe treated with other drug were from 37% (timolol) to 72% (bimatoprot) more likely to dicontinue and from 20% (timolol) to 58% (dorzolamide) more likely to dicontinue/change therapy (P < .001 for all comparion). At 12 month, 33% of patient treated with latanoprot and 19% of thoe receiving other ocular hypotenive had not dicontinued therapy; 23% and 13%, repectively, had not dicontinued or changed therapy. Compared with latanoprot, ignificantly higher percentage of patient treated with each alternate agent had only one fill of their index drug (P < .001). Concluion Although peritency rate were low acro agent, latanoprot-treated patient demontrated ignificantly greater peritency than did thoe treated with other topical ocular hypotenive therapie.