Análisis coste-eficacia hipotensora de los fármacos antiglaucomatosos más utilizados
- A Galindo-Ferreiro
- H Sánchez-Tocino
- M Fernández-Muñoz
- D Iglesias Cortiñas
ISSN: 0365-6691
Ano de publicación: 2004
Volume: 79
Número: 8
Páxinas: 379-384
Tipo: Artigo
Outras publicacións en: Archivos de la Sociedad Española de Oftalmologia
Resumo
Purpose: To evaluate the yearly cost and the cost-effectiveness of commercially available topical products in treatment of glaucoma. Methods: This analysis evaluates 12 topical agents in glaucoma: Betoptic, Betagan, Timoftol, Timogel, Alphagan, Lumigan, Travatan, Xalatan, Trusopt, Azopt. The number of drops per bottle of glaucoma medications is determined for all commercially tested products. The yearly cost of the dosage schedules was compared. We selected for each one 5 to 10-reported comparative hypotensive efficacy studies and we calculated the cost-effectiveness as the ratio between the yearly cost and the mean hypotensive efficacy. Results: The range of hypotensive efficacy of monotherapy components is from 13.8% to 31.9%. Lumigan and Xalatan present the highest hypotensive efficacy, 31.9% and 28.6% respectively. The cheapest medication is the beta-blockers group. The cost-efficacy ratio of glaucoma therapy is 1.5 for Timoftol, 2.8 for Betagan, 9.6 for Alphagan, 9.1 for Lumigan, 10.7 for Xalatan and 11.3 for Travatan. Conclusions: Over time, Lumigan is significantly most effective in controlling IOP. The cost-effectiveness for managing IOP will depend on both price and hypotensive efficacy. The beta-blockers group has lower hypotensive efficacy than prostaglandin analogs but cost-effectiveness is better in the former because of its low price.
Referencias bibliográficas
- Van Buskirk, EM, Cioffi, GA.. (1992). Glaucomatous optic neuropathy. Am J Ophthalmol. 113. 447-452
- Sommer, A.. (1990). Improving our understanding between pressure and glaucoma. Highlights of Ophthalmology.
- Salmon, JF.. (1999). Predisposing factors for chronic angle-closure glaucoma. Prog Retin Eye Res. 18. 121-132
- Kass, MA, Heuer, DK, Higginbotham, EJ, Johnson, CA, Keltner, JL, Miller, JP. (2002). The Ocular Hypertension Treatment Study: a randomized trial determines that topical ocular hypotensive medication delays or prevents the onset of primary open-angle glaucoma. Arch Ophthalmol. 120. 701-713
- (1998). The effectiveness of intraocular pressure reduction in the treatment of normal-tension glaucoma. Am J Ophthalmol. 126. 498-505
- Leske, MC, Heijl, A, Hussein, M, Bengtsson, B, Hyman, L, Honaroff, E. (2003). Factors for glaucoma progression and the effect of treatment: the early manifest glaucoma trial. Arch Ophthalmol. 121. 48-56
- Kobelt, G, Jonsson, L.. (1999). Modeling cost of treatment with new topical treatments for glaucoma: Results from France and the United Kingdom. Int J Technol Assess Health Care. 15. 207-219
- Marchetti, A, Magar, R, An, P, Nichol, M.. (2001). Clinical and economic impact of new trends in glaucoma treatment. MedGenMed. 3. 6
- Fiscella, RG.. (1998). Costs of glaucoma medications. Am J Health Syst Pharm. 55. 272-275
- Vold, SD, Wiggins, DA, Jackimiec, J.. (2000). Cost analysis of glaucoma medications. J Glaucoma. 9. 150-153
- Ikeda, H, Sato, E, Kitaura, T, Fukuchi, H, Kimura, Y, Kihira, K.. (2001). Daily cost of ophthalmic solutions for treating glaucoma in Japan. Jpn J Ophthalmol. 45. 99-102
- Walters, TR.. (1996). Development and use of brimonidine in treating acute and chronic elevations of intraocular pressure: a review of safety, efficacy, dose response, and dosing studies. Surv Ophthalmol. 41. 19-26
- Herkel, U, Pfeiffer, N.. (2001). Update on topical carbonic anhydrase inhibitors. Curr Opin Ophthalmol. 12. 88-93
- Fiscella, RG, Geller, JL, Gryz, LL, Wilensky, J, Viana, M.. (1999). Cost considerations of medical therapy for glaucoma. Am J Ophthalmol. 128. 426-433