Prostaglandin analogue use has grown at the expense of beta-blockers and trabeculectomy in Scotland

The increasing use of prostaglandin analogues in Scotland has led to an increase in prescribing rates and a rapid increase in cost, whilst prescribing of beta-blockers has declined and trabeculectomy rates have fallen, according to a study published in the February 2008 issue of Eye.

Dr Shona Macleod of Aberdeen Royal Infirmary and University of Aberdeen, Scotland and team evaluated the changing trends in glaucoma management in Scotland between 1994 and 2004 by conducting a retrospective analysis of national health statistics. The outcome measures were trabeculectomy rates, corrected for population likely to be at risk of glaucoma (PLG), prescribing volume and cost for glaucoma medications.

Between 1994 and 2004, PLG (calculated from estimates of prevalence in individuals aged 40 years and older, based on published epidemiological studies) increased by 16.6%. During the same time period, trabeculectomy rates fell from 46 per 1000 PLG in 1994 to 15.4 per 1000 PLG in 2004, a decrease of 67%. The cost of prescribing increased by 122% compared with an increase in number of items per 1000 PLG by 27.5%.

In 1994, beta-blockers accounted for 65.2% of prescribed drugs; by 2004, this had dropped to 33%. Since their introduction, the prescribing of prostaglandin analogues has increased rapidly and in 2004, they accounted for 39.4% of prescribed drugs.

Thus the rapidly rising cost of prostaglandin analogues has not impacted negatively on their use, which had in fact, by 2004 in Scotland, overtaken the prescribing of the more traditional beta-blockers and trabeculectomies.