title: Efficiency of glaucoma drug regulation in 5 European countries: a 1995-2006 longitudinal prescription analysis.
abstract: OBJECTIVE
  To compare the evolution of prostaglandin analog (PGA) and β-blocker (BB) prescriptions across 5 European countries.
  
  
  METHODS
  Data were extracted from various sources: (1) IMS data for France, Germany, Italy, Spain, and the United Kingdom, (2) glaucoma-treated patients from the United Kingdom General Practice Research Database (UK-GPRD), (3) prescriptions delivered by the territorial pharmaceutical service of Monselice of the Padova region (Italy). Drugs were grouped into 3 classes: PGAs, BBs, and other drugs. Yearly market shares were calculated. Treatment persistence survival curves were estimated for Italian and UK data, and the 3 drug groups were compared using the Cochran Mantel Haenszel test.
  
  
  RESULTS
  According to Padova data, BBs decreased in market share, whereas PGAs increased. A linear extrapolation of these market shares, based on 1998 to 2003 data, predicted that the 2 curves should cross in 2005, a prediction reinforced by the European Medicines Agency authorization (2002) of PGAs as first-line glaucoma treatments. That this did not occur may be explained by Italy's refusal to reimburse PGAs as first-line therapy. IMS data identified Italy and Germany as 2 countries in which BBs are still more frequently prescribed than PGAs. Treatment persistence with PGAs as monotherapy, in PGA-naive patients, was longer than for BBs according to both Padova and UK-GPRD data. This held true for both first-line and second-line PGA prescriptions (UK-GPRD); the persistence of second-line PGA equalled first-line BB treatment.
  
  
  CONCLUSIONS
  Health care regulations impacted upon glaucoma prescribing and may be one of the reasons for different annual evolution rates of PGA and BB prescriptions.
authors.affiliation: UO Oculistica di Monselice, Padova, Italy.
authors.forename: Renato
authors.initials: R
authors.lastname: De Natale
authors.forename: Claude
authors.initials: C
authors.lastname: Le Pen
authors.forename: Gilles
authors.initials: G
authors.lastname: Berdeaux
mesh_terms: D000319:Adrenergic beta-Antagonists / Q000191:economics / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000191:economics / Q000627:therapeutic use*; D003430:Cross-Sectional Studies; D016208:Databases, Factual; D003695:Delivery of Health Care / Q000331:legislation & jurisprudence*; D016527:Drug Costs; D004345:Drug Industry; D011307:Drug Prescriptions / Q000706:statistics & numerical data*; D004363:Drug Utilization / Q000706:statistics & numerical data; D004335:Drug and Narcotic Control / Q000331:legislation & jurisprudence*; D005062:European Union; D005901:Glaucoma / Q000188:drug therapy* / Q000191:economics; D006302:Health Services Research; D006801:Humans; D010818:Practice Patterns, Physicians'; D055553:Prescription Drugs; D011465:Prostaglandins, Synthetic / Q000191:economics / Q000627:therapeutic use; D040841:Resource Allocation
chemical_list: D000319:Adrenergic beta-Antagonists; D000959:Antihypertensive Agents; D055553:Prescription Drugs; D011465:Prostaglandins, Synthetic