Glaucoma refers to a group of chronic, progressive eye diseases caused primarily by elevated intraocular pressure (IOP) resulting from the blockage or decreased drainage of the aqueous humor through the eye’s trabecular meshwork in the drainage angle. Patients with ocular hypertension (OHT), who present with elevated IOP but have no other signs of glaucomatous damage, are at increased risk of developing primary open-angle glaucoma (POAG), the most common type of glaucoma. Treatment focuses on reducing and controlling IOP and preserving visual function by stabilizing optic nerves. Although prostaglandin analogues and beta blockers are the most frequently prescribed therapies, alpha agonists, carbonic anhydrase inhibitors, and parasympathomimetics (cholinergic agents) are also commonly prescribed. Patients are often treated with multiple mechanisms of action, either through polypharmacy or a fixed-dose combination therapy. Increased generic competition within the prostaglandin analogue, alpha agonist, and fixed-dose combination classes has put pressure on many of the more well-known brands in this market.
Using longitudinal U.S. claims data, this report examines current trends in the treatment of glaucoma (OHT and POAG) for both newly diagnosed patients and patients filling a prescription for a key therapy in the third quarter of 2013. For newly diagnosed patients, the report provides a quantitative analysis of treatment patterns and share by line of therapy, as well as progression between lines, duration of treatment on each line, and use of concomitant treatment. For recently treated patients, the report quantifies a drug’s source of business compared with its competitors and details which drugs precede others through an analysis of add-versus-switch patterns. Additional analyses explore persistency and compliance by brand.