Changes in Prices and Eye-Care Providers Prescribing Patterns of Glaucoma Medications in the United States Between 2013 and 2019

Abstract

Precis: Brand glaucoma medication prices vastly increased in the United States over the past 7 years, despite a reduction in eye-care providers’ tendency to prescribe brand medications over generics. Purpose: Determine the changes in prices of brand and generic glaucoma medications and to identify changes in eye-care providers prescribing patterns since 2013. Materials and Methods: The National Average Drug Acquisition Cost (NADAC) database (2013-2019) was used analyze per-unit drug price. Medicare Part D prescriber profile was used to identify eye-care providers prescribing patterns between 2013 and 2017. Results: Brand-name medication prices increased by 59% between 2013 and 2019, while generic medications decreased by 22%. Brand-name drugs were 13 to 162 times more expensive than their generic counterparts. Eye-care Providers prescribed 25% less brand name medications in 2017 compared with 2013. Conclusion: Brand glaucoma medication prices vastly increased in the United States over the past 7 years, despite a reduction in eye-care providers’ tendency to prescribe brand medications over generics. A change in government policy, allowing Medicare medication prices negotiations, could greatly reduce health expenditure on glaucoma treatment.

Minimally Invasive Micro Sclerostomy (MIMS) Procedure: A Novel Glaucoma Filtration Procedure

“…30 Medical therapy for glaucoma is an economic burden to many patients in that area, as many of them are not covered by any insurance plan/government reimbursement for their treatment. 31 The expenditure on antiglaucoma medications may exceed the monthly gross income. The low socioeconomic status of the population in that area, is reflected by the relatively small average number of hypotensive medications used preoperatively in this study.…”

“…Choice of primary therapeutic modality needs to be made on an individual patient basis 30. Medical therapy for glaucoma is an economic burden to many patients in that area, as many of them are not covered by any insurance plan/government reimbursement for their treatment 31. The expenditure on antiglaucoma medications may exceed the monthly gross income.…”

“…There was a relatively short follow-up period (24 wk and up to 52 wk) and a relatively limited number of subjects (31) in this study, out of which 23 subjects completed the study follow-up duration. They were also split into 2 groups (combined and a standalone procedure).…”

A Review of Cost-Effectiveness Analyses for Open Angle Glaucoma Management

“…3 With advancements in glaucoma management including the introduction of optical coherence tomography (OCT) imaging and minimally invasive procedures and the higher costs of medication, the cost of treatment has increased since 2013. 4 Although a significant portion of health care resources are spent on glaucoma management, clinical outcomes can vary widely. Despite the resources and costs spent on glaucoma management, as recently as 2022, the US Preventative Services Task Force has concluded that there is insufficient evidence to support screening for glaucoma in asymptomatic patients aged 40 or older.…”

“…For example, in 2006 total direct costs per year per patient ranged from $623 in glaucoma suspects or patients with earliest-stage disease to $2511 in end-stage disease 3 . With advancements in glaucoma management including the introduction of optical coherence tomography (OCT) imaging and minimally invasive procedures and the higher costs of medication, the cost of treatment has increased since 2013 4 . Although a significant portion of health care resources are spent on glaucoma management, clinical outcomes can vary widely.…”