Costs and persistence of brimonidine versus brinzolamide in everyday glaucoma care: an analysis conducted on the UK General Practitioner Research Database.
OBJECTIVE
To compare the persistence and costs of brimonidine versus brinzolamide therapy according to data collected by the UK General Practitioner Research Database (GPRD).


METHODS
Patients with diagnoses of ocular hypertension or glaucoma, or treated for glaucoma by surgery or laser therapy were identified. Selected patients were prescribed either brimonidine or brinzolamide as monotherapy. Treatment failure was defined as a glaucoma prescription change (adding, removing or replacing a drug, or initiating surgery or laser therapy). Times to treatment failure were compared with an adjusted Cox model using a propensity score method.


RESULTS
A total of 2,172 patients received brimonidine and 485 brinzolamide. Mean age was 69.5 years and 46.4% were male. Age and gender did not differ significantly whereas disease duration was longer with brinzolamide. Treatment failure at 1 year was experienced by 47.7% of patients given brinzolamide and by 55.9% given brimonidine (p<0.001). The hazard ratio for failure was less with brinzolamide (0.79: p<0.001) compared to brimonidine, after adjusting for age, gender, comorbidities and duration of follow-up. Adjusted annual costs of glaucoma management (in pound2005) were significantly (p<0.0042) lower with brinzolamide (pound196) than brimonidine (pound230).


CONCLUSIONS
According to data from everyday practice collected by the UK GPRD, brinzolamide was found to be more persistent than brimonidine when given as glaucoma monotherapy. Patients continued longer with brinzolamide treatment at a lower cost.
Lafuma
Antoine
A
Cemka, Bourg-la-Reine, France.
Laurendeau
Carolini
C
Berdeaux
Gilles
G
D000316:Adrenergic alpha-Agonists / Q000191:economics* / Q000627:therapeutic use; D000368:Aged; D000068438:Brimonidine Tartrate; D002257:Carbonic Anhydrase Inhibitors / Q000191:economics* / Q000627:therapeutic use; D015897:Comorbidity; D003362:Cost-Benefit Analysis; D004359:Drug Therapy, Combination; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000191:economics*; D006801:Humans; D007345:Insurance Claim Review; D008297:Male; D011810:Quinoxalines / Q000191:economics* / Q000627:therapeutic use; D013449:Sulfonamides / Q000191:economics* / Q000627:therapeutic use; D013843:Thiazines / Q000191:economics* / Q000627:therapeutic use; D013997:Time Factors
D000316:Adrenergic alpha-Agonists; D002257:Carbonic Anhydrase Inhibitors; D011810:Quinoxalines; D013449:Sulfonamides; D013843:Thiazines; D000068438:Brimonidine Tartrate; C111827:brinzolamide