Introduction Glaucoma is the leading cause of irreversible blindness worldwide. In Ghana, 19.4% of all blindness recorded is due to glaucoma. Reducing intraocular pressure medically (using eye drops) is the evidence-based therapeutic option. Objective To determine the rational use and undertake cost analysis of anti-glaucoma drugs among patients attending clinic at the Lions International Eye Centre (LIEC), Korle-Bu Teaching Hospital. Methods In this cross-sectional study, we reviewed all prescriptions presented to the pharmacy unit from 01/12/2015 to 31/03/2016. The dispensed drops were classified, and all anti-glaucoma drugs were identified. This was followed by cost analysis. Results A total of 588 prescriptions were captured, 27.3% (161/588) contained an anti-glaucoma medication. The mean number of anti-glaucoma medications was 1.71 of which 52.7% was prescribed to females. Prostaglandin analogs (PGA) were the most prescribed (37% (102/276)), followed by beta blockers (25.4% (70/276)), carbonic anhydrase group of medicines (16.3% (45/276)), combined beta blockers (11.2% (31/276)), alpha agonists (8.7% (24/276)) and miotics (1.4% (4/276)). The median (IQR) cost of anti-glaucoma therapy per prescription per month was GHC 65.00 (GHC38.5-GHC140) about [US$16.25 (US$ 9.6–US$35)]. Azopt (Brimonidine) was the most expensive with daily treatment cost of GHC 5.8 (about US$ 1.45), whilst the least expensive drug with a daily treatment cost of GHC 0.14 (about US$ 0.035) was timolol eye drops. Conclusion Prostaglandin analogs though expensive remain the most preferred treatment for managing glaucoma at the Korle-Bu Eye Centre in Ghana. This may adversely affect treatment among the poor since prostaglandins analogs are currently not covered by insurance.
The World Health Organization (WHO) addressed drug utilization as the marketing, distribution, prescription and use of drugs in a society, considering its consequences, either medical, social, (and) or economic. The increasing importance of drug utilization studies as a valuable investigative resource in pharmacoepidemiology has bridged it with other health related areas, such as public health. Surveillance of drug use by the doctors within the institution as well as in the community is assuming an increasingly key role in therapeutics. This was a cross-sectional study of prescription pattern and drug utilization trends at the Lions International Eye Centre (LIEC) of the Korle Bu Teaching Hospital and adherence to the standard prescription form at the Eye Centre. Prescriptions that were presented to the LIEC pharmacy unit within the period from October 2015 to March 2016 were captured and reviewed. The total number of drugs in the 588 prescriptions was 1265. The average number of drugs per prescription was 2.1. Drug dosage, route of administration, frequency, and duration of treatment record were mentioned in 95.01% (1202/1265), 97% (1227/1265), 98.46% (1240/1265) 96.05% (1215/1265) of the prescriptions respectively. Anti-glaucoma medicines were the most prescribed 21.8% (276/1265), Prescribing by generic name slightly dominated with 51.1% (645/1265) of the total number of drugs prescribed. Use of Ophthalmic antibiotics alone and the use of ophthalmic antibiotics in combination with other medicines were 13.5% (171/1265) and 11.9% (142/1265) respectively.: The findings of this study revealed that the drug utilization pattern was not in line with the recommended standard values of WHO prescribing indicators even though the level of compliance to the requirements on the standard prescription form of the hospital for drug prescribers was remarkably high. The availability of key medicines should be improved whilst generic prescribing from EDL should also be encouraged.
IntroductionGlaucoma is the leading cause of irreversible blindness worldwide. In Ghana, 19.4% of all blindness recorded is due to glaucoma. Reducing intraocular pressure medically (using eye drops) is the evidence-based therapeutic optionObjectives To determine the rational use and undertake cost analysis of anti-glaucoma drugs among patients attending clinic at the Lions International Eye Centre, Korle bu Teaching Hospital (LIEC).MethodsIn this cross sectional study, we reviewed all prescriptions presented to the pharmacy unit from 01/12/015 to 31/03/2016. The dispensed drops were classified and all anti-glaucoma drugs were identified. This was followed by cost analysis.ResultsA total of 588 prescriptions were captured, 27.3% (161/588) contained an anti-glaucoma medication. The mean number of anti-glaucoma medications was1.71 of which 52.7% was prescribed to females.Prostaglandin analogues were the most prescribed (37% (102/276)), followed by beta blockers (25.4% (70/276)), carbonic anhydrase group of medicines (16.3% (45/276)), combined beta blockers (11.2% (31/276)), alpha agonists (8.7% (24/276)) and miotics (1.4% (4/276)). The median (IQR) average cost of anti-glaucoma therapy per prescription per month was GHC 65.00 (GHC38.5-GHC140). Azopt (Brimonidine) was the most expensive with daily treatment cost of GHC 5.8 (about US$ 1.45), whilst the least expensive drug with a daily treatment cost of GHC 0.14 (about US$ 0.035) was timolol eye drops. ConclusionsProstaglandins analogues remain the most preferred treatment for managing glaucoma at the Korle-Bu Eye Centre in Ghana but are also the most costly. This may adversely affect treatment among the poor since prostaglandins are currently not reimbursed.
Canadian guidelines. A network meta-analysis was conducted to estimate the relative risk (RR) of treatment success with respect to vehicle, which was highest for HP/ TAZ (RR: 4.3) and lowest for TAZ (1.6). For responders, a 41.8% 8-week probability of relapse was applied for all treatments. Those who did not respond to topical treatment were assumed to receive either systemic or biologic treatment. The outcomes were healthcare costs (2018 CAD), quality-adjusted life years (QALYs) and incremental cost effectiveness ratio (ICER) per QALY. Results: HP/TAZ was associated with the lowest costs and highest QALYs over 3 years, which made it a dominant strategy relative to all other comparators.
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