Prescription trends for preservative free glaucoma medication in a public health system

Abstract

Purpose To analyze the prescribing trends over a 7-years period, between 2013 and 2020, in a tertiary hospital (Hospital Clinico San Carlos, Madrid, Spain) and its health area. Material and methods A retrospective study on the data collected from the information systems, “farm@web” and “Farmadrid”, of glaucoma prescriptions in the framework of a public health system (Spanish National Health System) during the last seven years. Results Prostaglandin analogues were the most commonly used drugs in monotherapy during the study period (range: 36.82% − 47.07%). Fixed combinations of topical hypotensives had an upward trend since 2013 (range: 39.99% − 54.21%), becoming the most dispensed drugs in 2020 (48.99%). Preservative-free eye drops (lacking benzalkonium chloride, BAK) have displaced preservative containing topical treatments in all pharmacological groups. In 2013, BAK-preserved eye drops accounted for 91.1% of the total prescriptions, however in 2020 they only accounted for 34.2% of total prescriptions. Conclusions The results of the present study highlight the current trend to avoid BAK-preserved eye drops for the treatment of glaucoma.

The PRAMOS Study: PRostaglandin Analogues Monotherapy—Awareness Survey on Ocular Surface Involvement

“…In England for example, a prescription cost analyses in the public domain describing primary care prescriptions showed that the PF prescriptions increased each year from 2009 but only reached 13.9% by 2018 [ 23 ]. On the other hand, similar results to ours were found in a recent paper that assessed the prescribing patterns of ocular hypotensive drugs in a public hospital in Spain [ 24 ]. In their study, latanoprost was also amongst the most prescribed drugs and the prescriptions of PF PG rose from 20% in 2013 to 85% in 2020.…”

“…Local tolerance of PG analogues has improved drastically since preservative-free (PF) eyedrops were put on the market, with many trials showing less signs and symptoms of ocular surface disease [ 17 , 21 , 22 ]. While one could expect all patients to be put on PF medications as a first-line therapy to maintain efficacy and local tolerance of these drugs, reality is that practices vary widely among practitioners and between countries [ 23 , 24 ]. However, as stated earlier, glaucoma treatment lasts for many years and its impact on the ocular surface can drastically affect patient adherence, especially that the disease is more frequent in the elderly, who also happen to have an increased prevalence of dry eye disease [ 25 ].…”

Management of Glaucoma-Related Dry Eye Disease with Intense Pulsed Light: A Randomized Control Study

“… 45 The efficacy of these treatments is contingent upon the consistent adherence of patients to prescribed regimens, which may entail the administration multiple times throughout the day. 45 , 46 Regrettably, the addition of topical ocular lubricants such as hyaluronic acid and diquafosol can negatively affect patient adherence to drugs for the treatment of glaucoma. 47 Therefore, similar to Lipiflow, the application of IPL therapy provides an alternative to topical antibiotics (to decrease the bacterial load), steroids, or cyclosporine in mitigating inflammation, and unlike TFLL profile enhancement achieved by systemic omega-3 supplementation or oral tetracycline as the dosage does not have to be maintained daily.…”

Preservative-Free Fixed Combination of Tafluprost 0.0015% and Timolol 0.5% for Treatment-Naive Patients with Open-Angle Glaucoma

“…Ocular surface disease is more common in individuals with glaucoma compared to the general population [ 10 , 11 ], and the application of topical medications containing preservatives may worsen inflammation, leading to suboptimal long-term therapeutic and surgical results as well as diminished quality of life [ 12 – 14 ]. Consequently, there is an increasing trend in the utilization of PF topical medications for glaucoma management [ 15 ].…”