Latanoprost more cost-effective than the rest

Latanoprost offers a more cost-effective strategy for the treatment of glaucoma than either dorzolamide or brimonidine, according to a study published in the February issue of the Canadian Journal of Ophthalmology.

Jean Lachaine and colleagues from the University of Ottawa Eye Institute, Ottawa, Canada conducted an economic analysis of the cost-effectiveness of prostaglandin analogues. Latanoprost was compared with timolol, dorzolamide and brimonidine, while travoprost was compared with timolol separately.

Compared with latanoprost, dorzolamide was not a cost-effective strategy. Compared with brimonidine, latanoprost provided a higher intraocular pressure (IOP) reduction with an incremental cost-effectiveness ratio of $16.17. However, the additional IOP reduction with latanoprost was obtained at a cost higher than the average cost per mmHg reduction obtained with brimonidine. Compared with timolol, latanoprost had a positive incremental cost-effectiveness ratio of $34.48 and $39.06, respectively.

As a first-line treatment for glaucoma, latanoprost is a more cost-effective strategy than dorzolamide and brimonidine. Latanoprost and travoprost are more effective than timolol but also more expensive. For those for whom timolol is not contraindicated, it may be preferable, from a cost-effectiveness point of view, to initiate treatment with timolol and reserve the prostaglandin analogues as an alternative treatment or as an add-on therapy for patients who do not achieve the required results with timolol alone.