Glaucoma treatment in Australia: changing patterns of therapy 1994-2003.
OBJECTIVE
To document the change in pattern of glaucoma treatment in Australia over the decade 1994-2003.


METHODS
Observational study: retrospective data audit.


RESULTS
The total number of prescriptions for glaucoma items has increased in this time period from 1.9 million to 3.3 million, with a cost increase to the Pharmaceutical Benefits Scheme (PBS) of in excess of 50m dollars. The largest increase has been in the class of prostaglandin analogues, which now comprise 49% of all glaucoma topical therapy prescriptions. Rates of laser trabeculoplasty and trabeculectomy surgery have fallen by 60% and 58%, respectively. Rates for secondary procedures such as repeat trabeculectomy, drainage implant devices and cycloablation have remained stable, although with some variation between Australian states.


CONCLUSIONS
The introduction of multiple new medications has resulted in a decline in the amount of glaucoma surgery and laser trabeculoplasty performed. There has been an associated increase in the total number of glaucoma prescription items dispensed, and a large increase in the cost to the PBS of this change. Outcome measures of the benefit of these changes are lacking.
Walland
Mark J
MJ
Royal Victorian Eye and Ear Hospital and Department of Surgery, Royal Melbourne Hospital (University of Melbourne), Melbourne, Victoria, Australia. mwalland@clyde.its.unimelb.edu.au
D000959:Antihypertensive Agents / Q000627:therapeutic use; D001315:Australia; D003695:Delivery of Health Care / Q000639:trends*; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D005901:Glaucoma / Q000628:therapy*; D006302:Health Services Research; D006801:Humans; D007349:Insurance, Health, Reimbursement / Q000639:trends; D007357:Insurance, Physician Services / Q000191:economics; D013508:Ophthalmologic Surgical Procedures / Q000639:trends*; D013222:State Medicine / Q000639:trends
D000959:Antihypertensive Agents