Costs and effectiveness of travoprost versus a dorzolamide + timolol fixed combination in first-line treatment of glaucoma: analysis conducted on the United Kingdom General Practitioner Research Database.
OBJECTIVE
To compare the effectiveness and associated costs of travoprost versus a fixed combination of dorzolamide + timolol as first-line therapy for glaucoma according to data collected by the United Kingdom General Practitioner Research Database (UK-GPRD).


METHODS
Patients with a diagnosis of ocular hypertension, glaucoma, or who had been treated topically by surgery or laser therapy were selected. Patients starting first-line treatment with travoprost or a fixed dorzolamide + timolol combination were included. Times to treatment failure were compared with an adjusted Cox model.


METHODS
Cost and treatment failure defined as a prescription change (adding or removing a topical treatment, or initiating laser therapy or surgery).


RESULTS
56 612 patients were extracted from the database and 39 808 patients received at least one topical prescription for IOP-lowering (intraocular pressure) therapy. Of these, 639 were treated with travoprost and 387 with dorzolamide + timolol, as first-line therapies. No significant difference was found between patient characteristics. Patients were aged 70.0 years and 48.5% were male. At 1 year, treatment failure was experienced by 30.4% of patients receiving travoprost and 49.4% receiving dorzolamide + timolol (p < 0.001). The hazard ratio for failure was 0.79 (p < 0.03) less with travoprost, after adjusting on age, gender, comorbidities and duration of follow-up. Adjusted annual costs of glaucoma management were significantly (p < 0.001) lower with travoprost ( pound198.31) than with dorzolamide + timolol ( pound312.21).


CONCLUSIONS
This retrospective costs and consequences analysis study showed that travoprost is more efficient than dorzolamide + timolol as first-line therapy for glaucoma patients. Patients continued longer with first-line treatment when prescribed travoprost at a lower cost.
Lafuma
A
A
Cemka, Bourg-la-Reine, France.
Berdeaux
G
G
D000368:Aged; D000959:Antihypertensive Agents / Q000191:economics* / Q000627:therapeutic use; D003008:Cloprostenol / Q000031:analogs & derivatives* / Q000191:economics / Q000627:therapeutic use; D003362:Cost-Benefit Analysis; D016208:Databases, Factual; D004338:Drug Combinations; D016527:Drug Costs; D005260:Female; D005901:Glaucoma / Q000188:drug therapy* / Q000191:economics; D006801:Humans; D008297:Male; D010821:Physicians, Family; D013449:Sulfonamides / Q000191:economics* / Q000627:therapeutic use; D013876:Thiophenes / Q000191:economics* / Q000627:therapeutic use; D013999:Timolol / Q000191:economics* / Q000627:therapeutic use; D000069557:Travoprost; D006113:United Kingdom
D000959:Antihypertensive Agents; D004338:Drug Combinations; D013449:Sulfonamides; D013876:Thiophenes; C479140:dorzolamide-timolol combination; D003008:Cloprostenol; D013999:Timolol; C062765:dorzolamide; D000069557:Travoprost