Real-World Treatment Patterns Of Cyclosporine Ophthalmic Emulsion And Lifitegrast Ophthalmic Solution Among Patients With Dry Eye

Abstract

Purpose

To assess adherence, non-persistence, discontinuation, and switching of topical cyclosporine ophthalmic emulsion 0.05% (CYC) and lifitegrast ophthalmic solution 5% (LIF) use in the real world among patients with dry eye disease (DED).

Design

Retrospective insurance claims study.

Methods

Adult patients with DED and ≥1 prescription claim for CYC or LIF (first claim = index date) in the IBM^® MarketScan^® databases from July 2016 to February 2018 were identified. Eligible patients had continuous medical and pharmacy benefits in the 12 months pre- and post-index periods, and no prior use of the index medication. The proportion of days covered (PDC), adherence, non-persistence, discontinuation, and switching were examined over the 12-month post-index period.

Results

This study included 6537 CYC and 3235 LIF patients. The adherence rate was 5.9% for CYC and 9.7% for LIF; the median PDC was 0.3 for both cohorts. Overall, 70.8% of CYC and 64.4% of LIF patients discontinued treatment with median days to discontinuation of 89 and 29, respectively. Non-persistence was 7.1% for CYC and 6.8% for LIF (median days to discontinuation: 89 and 105). In addition, 5.0% switched from CYC to LIF, and 9.6% switched from LIF to CYC over the post-index period.

Conclusion

Over 60% of DED patients discontinued treatment within 12 months of initiation; the median time to discontinuation was 3 months for CYC and 1 month for LIF. Although this analysis did not capture the reasons why patients discontinued treatment, the results demonstrate there likely exists a significant unmet need amongst DED patients.

Keywords:

• dry eye disease
• adherence
• persistence
• cyclosporine ophthalmic emulsion
• lifitegrast ophthalmic solution

Acknowledgments

The abstract of this paper was presented as a poster with interim findings at American Society of Cataract and Refractive Surgery (ASCR) annual meeting 2019 and the Academy of Managed Care Pharmacy (AMCP) annual meeting 2019. The ASCR poster’s abstract can be accessed via https://ascrs.confex.com/ascrs/19am/meetingapp.cgi/Paper/53018 (accessed on August 22, 2019). The AMCP poster is an encore presentation. This study was sponsored by Sun Pharmaceutical Industries Ltd, Princeton, NJ.

Disclosure

A. Ogundele and Y. Zhao are employed by Sun Pharmaceutical Industries. DE. White is affiliated with SkyVision Centers, and is a consultant for Sun Pharmaceutical Industries, Shire/Takeda Pharmaceuticals, Allergan, TearLab, Kala, and Eyevance. PM. Karpecki is a consultant for Aerie Pharmaceuticals, Akorn, Alcon, Allergan, Anthem, Avellino Labs, Bausch + Lomb, Beaver Visitech, BioTissue, Blephex, Bruder Healthcare, Cambium, DGH Technology, Essilor, EyeBrain/Neurolens, EyeGate, Eyemaginations/Rendia, Eyevance, Focus Labs, iCare USA, Imprimis, Ivantis, Jobson Medical Information/Web MD, Johnson & Johnson Vision, Konan Medical, MacuHealth, Maculogix, Notal Vision, Novartis, Oasis Medical, Ocular Sciences, Oculus, OcuMedic, OcuSoft, Oyster Point Medical, PECAA, Quark Pharmaceuticals, Refocus, Reichert/Ametek, Retina Sciences/EyeCheck, RxSight, Science Based Health, Sentiss Pharmaceuticals, SensiMed, Shire Pharmaceuticals, Sight Sciences, TelScreen, Total Eyecare Partners, Topcon, Visant Medical, Visionix, Vital Tears, Vmax, and Zeiss. PM. Karpecki is on the Board of Directors for Bruder Healthcare, LensTechs, Optometric Medical Solutions, Silk Technologies, and TearLab. PM. Karpecki also reports personal fees from Sun Pharmaceuticals, outside the submitted work. N, Fulcher, A. Acs and L. Moore-Schiltz are employees of IBM Watson Health, which received funding from Sun Pharmaceuticals Industries to conduct this study. The authors report no other conflicts of interest in this work.