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Abstract
Objective:
To compare patient adherence and persistence with bimatoprost 0.01%, a new formulation that offers equivalent intraocular pressure-lowering efficacy to bimatoprost 0.03% and improved tolerability, with that of the original bimatoprost 0.03% formulation.
Methods:
Pharmacy claims from a longitudinal database of prescription and medical claims for >115 million patients were analyzed. Patients with an initial (index) prescription for bimatoprost 0.01% or 0.03% between April and June 2011, and with no claim for ophthalmic prostaglandin or prostamide analogs during the preceding 18 months, were identified. Treatment adherence was expressed as the proportion of days covered (PDC) with study medication over the first 365 days after the index prescription. Treatment persistence over the first 12 months following the index prescription was assessed using Kaplan–Meier analyses, assuming a 30 day grace period for prescription refill. Treatment status (on/off study medication) was determined monthly for 12 months post-index.
Results:
In total, 6150 patients were assessed for treatment adherence and 7660 for persistence. Adherence was significantly better with bimatoprost 0.01% than bimatoprost 0.03% (mean PDC 0.540 vs. 0.438; p < 0.001). Significantly more patients had high adherence (PDC > 0.80) with bimatoprost 0.01% than 0.03% (29.1% vs. 17.3%; p < 0.001). Persistence was also significantly better with bimatoprost 0.01%, with 29.5% (95% confidence interval [CI]: 28.3%, 30.8%) versus 18.3% (95% CI: 16.8%, 19.9%) of patients remaining on continuous treatment for 12 months (p < 0.001). At 12 months, significantly more patients were ‘on treatment’ (continuing/restarting treatment) with bimatoprost 0.01% than 0.03% (48.8% vs. 33.9%; p < 0.001). Sensitivity analyses demonstrated similar findings in cohorts of ocular hypotensive treatment-naïve and elderly (≥65 years) patients.
Conclusions:
Bimatoprost 0.01% offers adherence and persistency advantages over bimatoprost 0.03% in patients requiring ocular hypotensive therapy. Study limitations included the observational design, lack of control for imbalances in patient characteristics, and assumption that prescription refill is synonymous with medication use.
Transparency
Declaration of funding
This study was sponsored by Allergan Inc., Irvine, CA, USA. The sponsor participated in the study design, data analysis and interpretation, and preparation and review of the manuscript.
Declaration of financial/other relationships
J.H.C., J.K. and V.D.P. are employees of Allergan Inc. G.S. has acted as a clinical expert consultant to Allergan Inc. for this project, but has not received any compensation. G.S. does receive ongoing research support from Allergan Inc. on other projects as well as from The Tissue Banks International. B.L. is an employee of Principled Strategies.
CMRO peer reviewers on this manuscript have received honoraria for their review work, but have no other relevant financial or other relationships to disclose.
Acknowledgments
Editorial support, including medical writing assistance with development of the first draft of the manuscript, revision of the manuscript based on author feedback, and styling the manuscript for journal submission, was provided by Andrew Fitton PhD and Diann Glickman PharmD of Evidence Scientific Solutions Inc. and was funded by Allergan Inc. Drop count data for calculation of days’ supply of study medication were kindly provided by Richard Fiscella, Allergan Inc., Irvine, CA, USA, and Sami Labib and Brian Maynard, Department of Pharmacy Practice, University of Illinois, Chicago, IL, USA.
Previous presentation: This paper has been presented in part at the American Glaucoma Society 2013 Annual Meeting, March 2, San Francisco, CA, USA.
Notes
*Lumigan is a registered trade name of Allergan Inc., Irvine, CA, USA.