Geographical variation in glaucoma prescribing trends in England 2008–2012: an observational ecological study

Heng, Jacob S; Wormald, Richard; Khaw, PT

doi:10.1136/bmjopen-2015-010429

Cited by 10 publications

(13 citation statements)

References 28 publications

(39 reference statements)

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“…Moreover, the preferred drug had been changed and combination therapy became a more favorable option. Prescription of glaucoma medications showed an upward trend between 2013 and 2017, which was basically consistent with previous reports in the literature [10]. An increasing Trends of glaucoma drug prescriptions number of patients with glaucoma was also revealed in another study [3].…”

Section: Discussionsupporting

confidence: 89%

Prescribing trends of glaucoma drugs in six major cities of China from 2013 to 2017

Ding

Luo

et al. 2020

PLoS ONE

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ObjectiveTo evaluate the prescribing trends of glaucoma drugs in six major cities of China from 2013 to 2017. MethodsA descriptive analysis using pharmacy prescription data was conducted. Outpatient prescription data was extracted from the Hospital Prescription Analysis Cooperative Project. Prescribing patterns, trends of visits, and corresponding expenditures for glaucoma medications were analyzed. ResultsA total of 84297 ambulatory prescriptions were included in the current study. Visits by glaucoma patients increased from 13808 in 2013 to 20060 in 2017. Over the same period, the yearly expenditure for glaucoma drugs increased from 2.33 million to 3.95 million Chinese Yuan (CNY). Among all the six classes of glaucoma drugs (prostaglandin analogues, carbonic anhydrase inhibitors, α-receptor agonists, β-receptor antagonists, cholinergic agonists and fixed combinations), β-receptor antagonists were the most commonly prescribed in 2013, accounting for 34.3% of patients, but gradually decreased to 27.1% in 2017. Prostaglandin analogues became the most frequently prescribed drugs in 2017, accounting for 30.2% of the visits. Prostaglandin analogues are the most expensive and yielded a total expenditure of 2.34 million CNY in 2017, followed by carbonic anhydrase inhibitors, α-receptor agonists, β-receptor antagonists, fixed combinations, and cholinergic agonists. Combination therapy became increasingly prescribed in 2017. ConclusionGlaucoma prescribing practices exhibited substantial changes over the study period. The number of glaucoma prescriptions continuously increased from 2013 to 2017, leading to increased prescription costs. These findings implied a similar trend observed in previous studies, as well as recommendations in the appropriate guidelines.

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Section: Discussionsupporting

confidence: 89%

Prescribing trends of glaucoma drugs in six major cities of China from 2013 to 2017

Ding

Luo

et al. 2020

PLoS ONE

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“…This has considerably lowered the cost for PGAs, and the conclusion is consistent with previous research in other regions (Heng et al. 2016).…”

Section: Discussionsupporting

confidence: 91%

“…2008; Connor & Fraser 2014; Heng et al. 2016). The increase in prescriptions might have several causes.…”

Section: Introductionmentioning

confidence: 99%

The future is old – Patients with topical ocular hypotensive treatment in the Nordic region between 2008 and 2017 with projections for 2040

Bro

Wickström

Lindén

2021

Acta Ophthalmologica

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The primary objective was to evaluate prescribing trends for topical ocular hypotensive treatment in the Nordic region during the last decade and, by population projections, estimate the glaucoma burden in 2040. A secondary objective was to analyse national variations in prescription patterns across the Nordic region.Methods: A retrospective analysis of national pharmacy data between 2008 and 2017 on the dispensation of topical ocular hypotensive treatment in the Nordic region was performed. Predictions of the glaucoma burden in 2040 were calculated from official population projections. Results:The total number of patients with ocular hypotensive treatment in the Nordic region increased from 346 000 to 418 000 (21%) between 2008 and 2017. The number of patients with ocular hypotensive treatment in the age group of 50 years and older increased from 3.6% to 3.9%. The daily defined dose (DDD) per patient and day during the study period increased from 1.22 to 1.26. Adjusted for beta-blocker combinations, the same value increased from 1.49 to 1.67. Across the Nordic countries, Finland had almost twice as many DDD per patient and day in 2017 (2.1) compared with Iceland (1.1). Between 2008 and 2017, the annual treatment cost for ocular hypotensive treatment in the Nordic region decreased from 96 million to 87 million Euro (À9%). In 2040, the number of patients with ocular hypotensive treatment in the Nordic region is estimated to 633 000 individuals (+51% compared with 2017). Conclusions:The study revealed an increased use of glaucoma medications in the Nordic region the last decade. This was mainly caused by an increased number of patients with ocular hypotensive treatment, but also because of a more intensive treatment. Marked national differences were detected. Due to the introduction of generic medications, the total cost for ocular hypotensive treatment did however decrease during the last decade. In 2040, the current number of individuals with ocular hypotensive treatment is estimated to have increased with an additional 50% due to a growing number of ageing individuals. This will lead to higher costs, not only for medications but also for diagnosing, monitoring and other aspects of glaucoma care.

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“…Geographical variations in prescription rates for glaucoma and ocular hypertension have been studied in England. 18 Cassard et al performed one of the largest national studies in the United States to elucidate the heterogenous distribution of glaucoma diagnosis across various regions. 19 They found that there were substantial regional differences in diagnosed rates for all types of glaucoma, even after adjusting for patient characteristics and provider concentration, suggesting possible over diagnosis in some areas and/or under diagnosis in other areas.…”

Section: Discussionmentioning

confidence: 99%

<p>GlaucoMap – Distribution of Glaucoma Surgical Procedures in the United States</p>

Anthony

Lee

Warren

et al. 2020

OPTH

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Purpose: To understand the distribution of trabeculectomies, glaucoma drainage implants (GDI) and micro-invasive glaucoma surgeries (MIGS) performed in the United States through geospatial mapping. Methods: We performed an observational cohort study to evaluate glaucoma surgeries in patients age ≥65. The most recently released data from Centers for Medicare Part B Carrier Summary Files were queried to determine the number of glaucoma surgeries performed per state during the year of 2017. We created choropleth maps, titled "GlaucoMap", to characterize the rates of various surgeries performed across the United States, defined as the number of procedures performed per 10,000 individuals. A chi-squared analysis was further used to evaluate differences in surgical preferences across geographic region. Standardized residuals (SR) were calculated to determine regional influences on surgical distribution. Results: There were 174,788 glaucoma surgeries performed: 22,862 trabeculectomies (13.1%), 19,991 GDI (11.4%) and 131,935 (75.5%) MIGS. The Northeast had the highest trabeculectomy rate, GDI was highest in the Southeast and MIGS were highest in the Southwest. There was a statistically significant difference in proportional use of conventional surgeries versus MIGS across various regions in the United States (p < 0.0001). Given the high trabeculectomy and GDI rates and relatively low MIGS adoption in the Southeast, we observed a +7.03 SR for conventional surgeries and −4.01 SR for MIGS. The Southwest and Western states had the highest MIGS rate and contributed +3.29 and +3.24 SR toward disproportional MIGS preference, respectively. The preference for conventional surgeries in the Northeast (SR = +2.93) and MIGS in the Midwest (SR = +0.99) also contribute to the overall differences in glaucoma surgeries across the United States. Conclusion: GlaucoMap is useful for visualizing the distribution of glaucoma surgeries in the United States. The heterogeneity in surgical preferences points to regional differences in glaucoma management.

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Geographical variation in glaucoma prescribing trends in England 2008–2012: an observational ecological study

Cited by 10 publications

References 28 publications

Prescribing trends of glaucoma drugs in six major cities of China from 2013 to 2017

Prescribing trends of glaucoma drugs in six major cities of China from 2013 to 2017

The future is old – Patients with topical ocular hypotensive treatment in the Nordic region between 2008 and 2017 with projections for 2040

<p>GlaucoMap – Distribution of Glaucoma Surgical Procedures in the United States</p>

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