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Costs Rising to Make Intraocular Pressure Fall
Glaucoma medications have risen in price almost universally since 1999, with one drug doubling in cost.
Per-bottle increases ranged from 0.62% for the generic β-blocker timolol maleate 0.5% to double for betaxolol 0.25% (Betoptic S), according to a prospective study in the January 2008 issue of the American Journal of Ophthalmology.
Cost per year for common glaucoma treatment regimens in 2006 ranged from $150.81 for timolol maleate 0.5% to $873.98 for a three-times-daily dose of brimonidine 0.15% (Alphagan P), said Nathan R. Rylander, M.D., and Steven D. Vold, M.D., of Texas A&M University here.
"Such a spectrum of cost for individual medications highlights the importance of considering the cost-effectiveness of glaucoma medical management," they wrote.
Following in the footsteps of researchers who estimated yearly medication costs in 1999, 2001, and 2003, Drs. Rylander and Vold calculated the costs for 2006 based on the average wholesale price and common dosing patterns.
They obtained 10 bottles of each of the various sizes of common brand-name topical glaucoma medications and a representative selection of generic formulations for a drop-by-drop comparison.
When the researchers counted the number of drops dispensed from each bottle and measured the actual volume, they found that bottles were typically overfilled by as much as 25.2% for latanoprost 2.5 mL (Xalatan) and 29.4% for bimatoprost 2.5 mL (Lumigan).
However, betaxolol 0.25%, brinzolamide (Azopt), dorzolamide (Trusopt), and generic carteolol 1.0% were usually slightly underfilled.
Using these laboratory-determined drop volumes, the least expensive medications at recommended daily dosing included:
* Among the brand-name products, Timoptic (timolol maleate) 0.5% in the 10.0 mL bottle size at $203.47 a year with a twice-daily dosing regimen.
* Generic timolol maleate 0.5% in the 15.0 mL bottle size at $150.81 a year with a twice-daily dosing regimen.
* Generic metipranolol 0.3% in the 10.0 mL bottle size at $151.96 a year for twice-daily dosing.
The most expensive medications were the combination of timolol 0.5% and dorzolamide 2.0% (Cosopt) at $697.42 and a three-times-daily dosing of Alphagan P 0.15% at up to $873.98 per year.