title: Predicted patient demand for a new delivery system for glaucoma medicine.
abstract: Sustained-release drug delivery systems that replace the need for daily glaucoma medications will improve outcomes for those who are nonadherent and reduce the inconvenience of having to take medications on a recurring basis.The objective is to estimate uptake (i.e., demand) for a new technology that delivers sustained-release glaucoma medication and to investigate how uptake varies by product attributes, physician recommendations, peer adoption (i.e., percentage of patients seen in a clinic using the new technology), and patient characteristics.In a web-enabled discrete-choice experiment survey, glaucoma patients in the United States were asked to choose between continuing eye drop use or purchasing the new delivery system. In a cross-sectional web-enabled survey, ophthalmologists were asked their likelihood of recommending the new technology based on product and patient characteristics.Study participants were 500 glaucoma patients who were on topical administration of daily eye drops and 155 ophthalmologists who practice in the US.Main outcomes were predicted uptake for patients and likelihood of recommending a new drug delivery system for ophthalmologists. Logistic models were used to analyze the choice data.Uptake was estimated to be 18% at an annual cost of $1000 and to be 24% when the cost was $500. A physician's recommendation increased uptake by 6% to 12%, whereas an increase in peer adoption from 5% to 50% increased uptake by 3% to 7%. Patients aged ≥ 65 and those with lower income were more likely to remain on eye drops. Physicians were more likely to recommend a product if the interval between administrations is 6 months or longer and when long-term safety and efficacy data are available. They were less likely to recommend it to patients with lower income and no adherence problems.Results suggest a significant interest in an injectable solution or other sustained-release alternatives to daily eye drops. However, in this survey, patient uptake was greatly influenced by out-of-pocket cost and the interval between treatment administrations. Few physicians were willing to recommend sustained-release technology if the treatment interval was less than 3 months.
authors.affiliation: Health Services and Systems Research Programme, Duke-NUS Medical School Glaucoma Department, Singapore National Eye Centre, Singapore School of Medicine, Duke University, Durham, NC.
authors.forename: Semra
authors.initials: S
authors.lastname: Ozdemir
authors.forename: Tina T
authors.initials: TT
authors.lastname: Wong
authors.forename: Robert Rand
authors.initials: RR
authors.lastname: Allingham
authors.forename: Eric A
authors.initials: EA
authors.lastname: Finkelstein
mesh_terms: D000287:Administration, Topical; D000328:Adult; D000368:Aged; D003430:Cross-Sectional Studies; D003692:Delayed-Action Preparations; D016503:Drug Delivery Systems; D005260:Female; D005544:Forecasting; D005901:Glaucoma / Q000188:drug therapy / Q000523:psychology*; D006301:Health Services Needs and Demand / Q000639:trends*; D006801:Humans; D016015:Logistic Models; D008297:Male; D055118:Medication Adherence; D008875:Middle Aged; D009883:Ophthalmic Solutions / Q000008:administration & dosage*; D000072163:Ophthalmologists / Q000523:psychology; D057240:Patient Preference / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D014481:United States
chemical_list: D003692:Delayed-Action Preparations; D009883:Ophthalmic Solutions