Estimated comparative costs of achieving a 20% reduction in intraocular pressure with bimatoprost or latanoprost in patients with glaucoma or ocular hypertension.
BACKGROUND
Although the probability of treatment success should be the primary factor guiding the choice of an intraocular pressure (IOP)-lowering medication, treatment cost is also important to physicians, patients and third-party payers. The objective of the present study was to compare the cost effectiveness of bimatoprost with that of latanoprost in the treatment of glaucoma and ocular hypertension.


METHODS
Estimated yearly costs and cost per treatment success for bimatoprost ophthalmic solution 0.03% once daily (Lumigan), Allergan, Inc., Irvine, CA, USA) were compared with those for latanoprost ophthalmic solution 0.005% once daily (Xalatan), Pfizer, Inc., New York, NY, USA). The pharmacoeconomic model was based on medical resource costs and the percentage of patients achieving > or =20% decrease in IOP from baseline at 8:00 am, 12:00 pm and 4:00 pm after 6 months of treatment (clinical success rate). Calculations were also made using the average success rate throughout the day and the average success rate minus the percentage of patients who withdrew from treatment as a result of adverse events.


RESULTS
After 6 months of treatment, the clinical success rates were significantly higher with bimatoprost than with latanoprost (p < or = 0.003). The average expected yearly cost per patient was similar for bimatoprost (US1151 dollars) and latanoprost (US1193 dollars). The cost per treatment success, however, averaged US568 dollars less with bimatoprost (US1501 dollars/success) than with latanoprost (US2069 dollars/success). This was true even when the percentage of patients who withdrew from treatment as a result of adverse events was subtracted from the clinical success rate.


CONCLUSIONS
The greater efficacy of bimatoprost resulted in a lower cost per treatment success than was seen with latanoprost. This remained true even when responder rates were adjusted by subtracting the percentage of patients who withdrew from treatment as a result of adverse events.
Fiscella
Richard
R
Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, Illinois 60612, USA. Fisc@uic.edu
Walt
John
J
D000465:Algorithms; D000577:Amides / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D000069580:Bimatoprost; D003008:Cloprostenol / Q000031:analogs & derivatives; D003362:Cost-Benefit Analysis; D016527:Drug Costs; D005901:Glaucoma / Q000188:drug therapy / Q000191:economics*; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D000077338:Latanoprost; D008055:Lipids / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D015233:Models, Statistical; D009798:Ocular Hypertension / Q000188:drug therapy / Q000191:economics; D011461:Prostaglandins F, Synthetic / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D016896:Treatment Outcome
D000577:Amides; D000959:Antihypertensive Agents; D008055:Lipids; D011461:Prostaglandins F, Synthetic; D003008:Cloprostenol; D000077338:Latanoprost; D000069580:Bimatoprost