Daily cost of newer glaucoma agents

The purpose of this study was to evaluate the drop characteristics of newer glaucoma medicines compared to timolol solution and timolol gel forming so lution (Timoptic-XE(TM), Merck). We evaluated latanoprost 0.005% (2.5 mi bottle), brimonidine 0.2%, apraclon idine 0.5%, dorzolamide 2%, timolol solution 0.5% (5 and 10 mi bottles), an d timolol gel forming solution 0.5% (5 mi bottle) in 14 patients with prima ry open-angle glaucoma or ocular hypertension. Each patient placed 10 drops onto an analytical scale (one drop every 10 seconds) for all ten preparati ons. Patients then attempted to instill 10 drops of a tear replacement solu tion into their ocular cul-de-sac. Medication bottles were weighed before a nd after patients dispensed from the bottle and then after the bottle was e mptied. Weights were converted to volume using the density of the medicine. A statistical difference existed between groups for mean drop volume with l atanoprost having the smallest drop volume (.0273 +/- .004 mi) (P<0.005). A ll manufacturers filled correctly or overfilled their bottles with product and had <10% of medicine wasted. Patients instilled 77.9% of the tear solut ion correctly. When dosed according to labeling, latanoprost had the lowest cost of therapy at $0.87 daily compared to the other newly released medica tions (range $1.05 to $1.40). Latanoprost was more expensive, however, than timolol maleate solution or gel (range $0.45 to $0.54 per day). Latanoprost therapy is less expensive per day than dorzolamide, brimonidine or apraclonidine, but more expensive than timolol maleate. Cost per day co uld be further reduced by limiting medicine wastage upon instillation, howe ver.