Glaucoma Therapy: Prescribing Pattern and Cost Analysis

In the present study out of total 200 prescriptions of POAG (primary open angle glaucoma) studied 66% were found to be of monotherapy including timolol, brimonidine, pilocarpine, betaxolol, levobunolol, latanoprost and apraclonidine in 30%, 15 %, 6%, 8% , 4%, 1% and 2% of the prescriptions respectively and 34% were found to be of polypharmacy with timolol+pilocarpine, timolol+acetazolamide, timolol+ brimonidine and betaxolol+brimonidine in 13%, 4%, 8% and 9% of the prescriptions respectively. 10% drugs were prescribed by generic name. Written instruction to the patients regarding dose and dosing interval was mentioned in 100% prescriptions, but the proper method of instillation was mentioned only in 15% of the prescriptions. Results of the present study clearly indicated urgent need for prescribers to improve their communication skills, to give proper instructions to the patient regarding instillation of drug, as little bit of caution like instillation from the side of the eye in the supine position followed by rolling of the eyeball can decrease the wastage, decrease cost and improve compliance. However, in the present scenario cost of the traditional medications like betablockers, pilocarpine etc. is found to be much less than newer medications (prostaglandin analogues, brimonidine). Moreover, in presence of wide cost variation among various brands of the same drug our study could help the opthalmologist to use all possible measures of pharmacoeconomics while prescribing an antiglaucoma drug.