OBJECTIVES

Patients with glaucoma who have lower rates of compliance are presumed to be at greater risk of developing progressive visual loss. Prostaglandin analogs (PGAs) are recommended as initial therapy to lower intraocular pressure in glaucoma patients. This research aims to compare persistence and compliance on latanoprost, bimatoprost and travoprost, at various time points within a 12-month analysis period.

METHODS

Data were obtained from the IQVIA Canadian Private Drug Plan (PDP) and Ontario Drug Benefit (ODB) databases, which track reimbursed drug transactions for anonymized patients. Patients were indexed on the date of first claim for the specified product within a 12-month period, and followed for 3, 6 and 12 months. Persistence was measured from index to first observed significant gap in therapy (days supplied of claim with an allowable grace period of 90 days) and output as a Kaplan-Meier curve. Compliance was measured as a Medication Possession Ratio (MPR) using a fixed denominator consistent with analysis period (i.e.: 90 days [3 months], 180 days [6 months] and 365 days [12 months]) and compared using a Fisher’s Exact test.

RESULTS

From a cohort of 53,244 patients (bimatoprost n-25,116, latanoprost n-18,224, travoprost n-9,904), those indexing on latanoprost demonstrate significantly higher persistence at 3, 6 and 12 months (67.23%, 54.98%, 41.47% respectively, p<0.001) compared to bimatoprost (58.04%, 44.22%, 30.82%, respectively) and travoprost (51.54%, 36.92%, 23.21% respectively). Similarly, latanoprost has a significantly higher proportion of patients with an MPR of ≥80% at 3, 6, and 12 months (27.54%, 18.66%, 12.79% respectively, p<0.001) compared to bimatoprost (18.90%, 11.51%, 7.21%, respectively) and travoprost (16.86%, 9.90%, 5.35% respectively).

CONCLUSIONS

Patients initiating on latanoprost have superior persistence and compliance compared to other key PGAs in the Canadian population studied. However, there remains a need for improved persistence and compliance with PGAs to prevent vision loss among patients.