The use of ocular hypotensive drugs for glaucoma treatment: changing trend in Taiwan from 1997 to 2007.

Abstract

Treatment of glaucoma has increasingly favored better intraocular pressure (IOP) lowering efficacy and safety of topical medications. The introduction of newer ocular hypotensive drugs (OHDs) has led changes in the prescribing patterns and treatment approaches. This study aimed to investigate the prescribing patterns, trends, and corresponding expenditures of OHDs in Taiwan over an 11-year period from 1997 to 2007. A nationally representative sample of 1 million ambulatory visits from the National Health Research Institute data sets was used. Patients with glaucoma who aged ≥18 years were identified with ICD-9-CM and A230 codes. Six categories of OHDs were used to describe the rates, patterns, expenditures, and changes of annual prescriptions for glaucoma patients. The number of OHD prescriptions has tripled during the 11 years. Although the prescribing trend was being away from monotherapy with β-blockers, this class remained the most commonly used OHD up to 2007. Prostaglandin analogs were the second most frequently prescribed OHDs since 2000. Changing prescribing patterns and increased patients were the main contributors to the rise in OHD expenditures. Part of increased expenditure was likely offset by reduced needs for laser and surgical interventions. The prescriptions of OHDs are shifting to newer categories and combination therapy. These findings provided insights into recent trends in management of glaucoma patients in Taiwan and implied a similar trend toward recent clinical reports and practices recommendations in the guidelines.