A European perspective on costs and cost effectiveness of ophthalmic combinations in the treatment of open-angle glaucoma.
OBJECTIVE
Efficacy, safety, and cost implications are important considerations when choosing an ophthalmic treatment. Fixed-combination glaucoma medications containing brimonidine 0.2% and timolol 0.5%, or dorzolamide 2% and timolol 0.5%, were compared with brimonidine 0.2% and dorzolamide 2% that were used as adjunctive therapy to timolol 0.5%.


METHODS
A literature review was conducted to determine the outcome parameters of intraocular pressure reduction and tolerability after 3 months of use of brimonidine or dorzolamide, each together with timolol as a fixed-combination or in concomitant therapy. Modelled cost-minimization and cost-effectiveness analyses were performed to investigate the economic consequences of ophthalmic therapy with brimonidine, dorzolamide, and timolol from a societal perspective.


RESULTS
The literature review found that brimonidine and dorzolamide used as fixed combinations with timolol as well as in adjunctive therapy to timolol were equally effective and safe. Furthermore, in the European countries studied, the fixed combination of brimonidine/timolol represented a less costly option when compared to the fixed combination of dorzolamide/timolol evaluated over both a 3-month and a 12-month horizon.


CONCLUSIONS
Brimonidine used as a fixed-combination therapy with timolol provided better cost value than dorzolamide/timolol in all the countries studied. For most countries, the fixed combination of brimonidine and timolol also provided better cost value than adjunctive therapy with brimonidine, which was more cost effective than adjunctive therapy with dorzolamide.
Hommer
A
A
Krankenanstalt Sanatorium, Vienna - Austria.
Thygesen
J
J
Ferreras
A
A
Wickstrom
J
J
Friis
M M
MM
Buchholz
P
P
Walt
J G
JG
D000959:Antihypertensive Agents / Q000009:adverse effects / Q000191:economics*; D000068438:Brimonidine Tartrate; D003362:Cost-Benefit Analysis; D004338:Drug Combinations; D016527:Drug Costs; D004359:Drug Therapy, Combination; D005060:Europe; D005902:Glaucoma, Open-Angle / Q000188:drug therapy / Q000191:economics*; D017048:Health Care Costs; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects; D008875:Middle Aged; D009313:National Health Programs / Q000191:economics; D009883:Ophthalmic Solutions / Q000009:adverse effects / Q000191:economics*; D011810:Quinoxalines / Q000009:adverse effects / Q000191:economics; D013449:Sulfonamides / Q000009:adverse effects / Q000191:economics; D013876:Thiophenes / Q000009:adverse effects / Q000191:economics; D013999:Timolol / Q000009:adverse effects / Q000191:economics; D016896:Treatment Outcome
D000959:Antihypertensive Agents; D004338:Drug Combinations; D009883:Ophthalmic Solutions; D011810:Quinoxalines; D013449:Sulfonamides; D013876:Thiophenes; D000068438:Brimonidine Tartrate; D013999:Timolol; C062765:dorzolamide