Prescribing Trends of Topical Glaucoma Medications in Australia From 2001 to 2017

Abstract

Precis: As new glaucoma treatments arise, including minimally invasive glaucoma surgeries and new classes of glaucoma medications, it is important to examine the prescription trends of current topical glaucoma medications and how they may change. Purpose: To determine the prescribing trends of topical glaucoma medications in Australia from 2001 to 2017. Methods and Analysis: Pharmaceutical Benefits Scheme (PBS) item numbers were used to determine glaucoma medication prescribing rates from 2001 to 2017. All data were adjusted for population (/100,000) as per the Australian Bureau of Statistics (ABS) population data. Results: Overall prescription rates for glaucoma medications ranged between 67,904 and 86,936 per 100,000 from 2001 to 2017. An upward trend was noted from 2001 to 2015, with the exception of a notable decline in 2013 by 14.7%, before then increasing by 13.7% in 2014. After 2015, prescribing rates were seen to decrease over the subsequent years in the study period. Latanoprost remained the most prescribed medication and prostaglandin the most prescribed class. Prescribing rates of single-agent beta-blockers were noted to decrease during the 17-year period, particularly with the introduction of combination agents, which note an upward trend. Brinzolamide/brimonidine has increased by 50.0% from 2016 to 2017. Conclusions: Total rates of prescriptions have remained relatively stable from 2001 to 2017. The number of medications prescribed when considering combination agents separately was seen to be increasing from 2001 to 2015. From 2015 to 2017, a downward trend was noted in the number of medications prescribed. Prostaglandins remain the most prescribed class throughout the study period.

Nation-Wide Analysis of Glaucoma Medication Prescription in Fiscal Year of 2019 in Japan

“…In the Japan Health Insurance Society database who were newly diagnosed with glaucoma, initial prescription of PGF 2α showed significantly better patient persistence than β-blockers and CAIs [ 19 ]. In Australia, decrease of single-agent β-blockers was particular with the introduction of FDCs, which noted an upward trend [ 10 ]. Among patients who were prescribed PGF 2α as an initial medical treatment, 30% of the patients required adjunctive therapy within 1 year, and FDCs were the most common initial adjunctive therapy [ 20 ].…”

“…To date, analysis of glaucoma medication prescription was conducted by nationwide studies using the database from medical insurance claims of hospitals and pharmacies, or from a large-scale cohort study [ 3 , 4 , 5 , 6 ]. The trends of medication prescription have been changed by various factors such as the appearance of new medication classes and regimens [ 4 , 5 , 7 , 8 ], the appearance of alternative treatments other than medication [ 9 , 10 , 11 ], or an increase of the glaucoma patients and aged population [ 4 , 12 , 13 ]. Therefore, continuing updates for the database and its analysis are required to understand the current status of glaucoma medication usage.…”

Xalatan in the Treatment of Primary Open-Angle Glaucoma. Review

“…По-прежнему, несмотря на появление на рынке других аналогичных препаратов и дженериков, латанопрост остается наиболее часто назначаемым антиглаукомным препаратом не только в России, но и в странах Европы, США, Японии, Китае и Австралии [20][21][22][23][24]. Из всех гипотензивных препаратов латанопрост является единственным аналогом простагландина, включенным в регулярно пересматривающийся «Список важнейших лекарственных средств ВОЗ».…”

Glaucoma treatment and deprivation: time-series analysis of general practice prescribing in England

“…Only lowering intraocular pressure has proven effectiveness in slowing progression 4 . While surgery and selective laser trabeculoplasty (SLT) are important when appropriate, with the latter being recommended as first line treatment within the updated National Institute for Health and Care Excellence (NICE) guideline in 2022 5 , medical treatment has been the mainstay of treatment 6 . Once diagnosed, prescribing typically remains in primary care supported by secondary care.…”

“…Indeed, prostaglandin analogues (PGAs) were established as first-line treatment by 2003 9 , and the impact of NICE updates 10 in 2017 and 2022 have not yet been established. A recent Australian study 6 observed prescribing rates remaining stable from 2001-2017, with PGAs being the most prescribed class. The expected hierarchy is PGA first line eyedrops, betablockers second line, with carbonic anhydrase inhibitors and alpha-agonists third line choices 11 .…”