title: A pharmacoeconomic analysis to determine the relative cost-effectiveness of bimatoprost 0.03% eye drops and brimonidine 0.2% eye drops in patients of primary open-angle glaucoma/ocular hypertension.
abstract: OBJECTIVE
  The aim was to compare efficacy and cost-effectiveness of bimatoprost 0.03% and brimonidine 0.2% in primary open-angle glaucoma (POAG)/ocular hypertension (OHT).
  
  
  METHODS
  Open, randomized, cross-over, comparative study.
  
  
  METHODS
  Forty patients of POAG or OHT with intraocular pressure (IOP) <30 mm Hg were included in the study after a written informed consent. The patients were divided randomly into two groups of 20 patients each. Patients of group A were administered bimatoprost 0.03% eye drops once daily, and those of group B brimonidine 0.2% eye drops twice daily for a period of 4 weeks. After a washout period of 4 weeks, the patients were crossed over that is, group A was administered brimonidine 0.2% and group B bimatoprost 0.03%. Fall in IOP at 4 weeks was recorded. The daily cost of each drug was calculated by maximum retail price and the average number of drops per bottle. The cost-effectiveness was then calculated as the cost of drug/mm Hg fall in IOP.
  
  
  METHODS
  Independent samples t-test was used to compare the efficacy of both drugs.
  
  
  RESULTS
  IOP lowering with bimatoprost (8.9 ± 1.598 mm Hg) was significantly (P < 0.0001) higher than brimonidine (6.55 ± 1.26 mm Hg). The number of drops/ml were 33.43 ± 0.52 and 25.49 ± 0.26, respectively, for bimatoprost and brimonidine. Treatment with bimatoprost was costlier than brimonidine with daily costs/eye Rs. 4.02 ± 0.06 and 3.14 ± 0.03, yearly costs/eye Rs. 1467.46 ± 20.74 and 1147.75 ± 11.15, respectively. Bimatoprost was more cost-effective than brimonidine with the cost-effectiveness ratio (CER) respectively Rs. 13.10 ± 2.61/mm Hg and Rs. 13.96 ± 2.86/mm Hg. Incremental CER Rs. 10.43/mm Hg implies lower costs/mm Hg extra IOP lowering by bimatoprost than Rs. 13.96 for brimonidine.
  
  
  CONCLUSIONS
  In spite of being costlier, bimatoprost is more efficacious and cost-effective than brimonidine.
authors.affiliation: Department of Health and Family Welfare, CHC Manawala, SGRD Institute of Medical Sciences and Research, Amritsar, India.
authors.forename: Navreet Kaur
authors.initials: NK
authors.lastname: Natt
authors.forename: A
authors.initials: A
authors.lastname: Gupta
authors.forename: G
authors.initials: G
authors.lastname: Singh
authors.forename: T
authors.initials: T
authors.lastname: Singh
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000959:Antihypertensive Agents / Q000008:administration & dosage; D000069580:Bimatoprost / Q000008:administration & dosage*; D000068438:Brimonidine Tartrate / Q000008:administration & dosage*; D003362:Cost-Benefit Analysis; D018592:Cross-Over Studies; D004305:Dose-Response Relationship, Drug; D017850:Economics, Pharmaceutical; D005260:Female; D005902:Glaucoma, Open-Angle / Q000188:drug therapy* / Q000191:economics / Q000503:physiopathology; D006801:Humans; D007429:Intraocular Pressure / Q000187:drug effects*; D008297:Male; D008875:Middle Aged; D009798:Ocular Hypertension / Q000188:drug therapy* / Q000191:economics / Q000503:physiopathology; D009883:Ophthalmic Solutions
chemical_list: D000959:Antihypertensive Agents; D009883:Ophthalmic Solutions; D000068438:Brimonidine Tartrate; D000069580:Bimatoprost