title: Cost Analysis of Commonly used Combination of Drugs in Primary Open Angle Glaucoma.
abstract: BACKGROUND
  Glaucoma is second cause of blindness in the world. The financial burden on the patient during long-term treatment is immense and affects the compliance to medications, thus visual morbidity.
  
  
  OBJECTIVE
  To analyse economic impact of three commonly used drug combinations (Dorzolamide + Timolol = DT; Brimonidine + Timolol = BT; Latanoprost+Timolol = LT) in primary open angle glaucoma.
  
  
  METHODS
  This observational, prospective study was undertaken at M & J Institute of Ophthalmology, Civil Hospital, Ahmedabad, a western regional institute of Ophthalmology. A total of 257 patients were included in the study. Only101 patients could complete the 6 month follow-up, of which 35, 34 and 32 patients belonged to DT, BT and LT group respectively. Cost of drug, details of the transportation were noted at every visit. Total cost incurred per patient/eye was calculated. Cost effectiveness was calculated by cost per mm Hg IOP (Intra-Ocular Pressure) reduction.
  
  
  RESULTS
  Treatment with DT, BT & LT group consumed 8.6%, 4.6% and 7.7% of the per annum income of the family, respectively. Cost of medications per annum (in INR)/eye for DT, BT & LT group were 2562 ± 15.74, 1544 ± 32.06, 3876 ± 73.68 (Mean±SEM) respectively. Additional cost of travelling was different for patients coming from Ahmedabad (Locals) and outsiders (patients coming outside Ahmedabad, India). Outsiders has to bear the brunt of higher transport charges, where they spent an average of Rs. 914, 856 & 933 per annum (5 follow-ups), whereas, Locals spent an average of Rs. 104, 112, 100 for DT, BT & LT group respectively.
  
  
  CONCLUSIONS
  Treatment with BT was found to be most cost-effective among three groups. Drug therapy takes substantial amount from per annum income of family and was an important compliance factor in the treatment of POAG.
authors.affiliation: Assistant Professor, Department of Pharmacology, BLDE University's Shri B. M. Patil Medical College , Vijayapura (Bijapur), Karnataka, India .
authors.forename: Shivaprasad Kalakappa
authors.initials: SK
authors.lastname: Kumbar
authors.affiliation: Assistant Professor, Department of Pharmacology, BLDE University's Shri B. M. Patil Medical College , Vijayapura (Bijapur), Karnataka, India .
authors.forename: Mrutyunjay
authors.initials: M
authors.lastname: Mirje
authors.affiliation: Lecturer, Department of Pharmacology, BLDE University's Shri B. M. Patil Medical College , Vijayapura (Bijapur), Karnataka, India .
authors.forename: Gurudatta
authors.initials: G
authors.lastname: Moharir
authors.affiliation: Lecturer, Department of Pharmacology, BLDE University's Shri B. M. Patil Medical College , Vijayapura (Bijapur), Karnataka, India .
authors.forename: Ambadasu
authors.initials: A
authors.lastname: Bharatha
keywords: Cost-effectiveness; Drug Combinations; Economics; Intra-ocular Pressure