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Patient compliance improves with use of generic glaucoma drugs
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Patients who switched to generic latanoprost were more likely to adhere to their drug regimens, according to a study recently published in Ophthalmology.
Stein and colleagues conducted a longitudinal cohort analysis of 8,427 patients older than 40 years with open-angle glaucoma.
Researchers measured adherence rates for topical prostaglandin analog use both 18 months before and after the introduction of generic latanoprost. They compared the rates of patients who continued the use of name brand prostaglandin analogs after generic availability with the rates of patients who switched to generic latanoprost.
Results showed that patients who continued the use of name brand prostaglandin analogs (PGAs) were 39% more likely to demonstrate reduced adherence and 28% less likely to demonstrate improved adherence. Additionally, researchers reported that improved adherence after the generic drug was introduced was associated with the black race, lower copay post-introduction and higher copay pre-introduction.
"This study highlights the impact of medication cost and access to generic PGAs on medication adherence," the authors concluded. "We identified a subset of patients who clearly exhibited an improvement in adherence when they were switched from a brand-name PGA to generic latanoprost."
They continued: "When clinicians know or suspect that a patient is struggling with adherence, attempts should be made, whenever feasible, to switch such patients to generic glaucoma medications. This can be particularly helpful for patients with high copays and racial minorities."
Disclosure: The authors report no relevant financial disclosures.
Perspective
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Blair Lonsberry, OD, FAAO
Adherence to glaucoma medications is a complex and significant issue for both patient and clinician. With the introduction of generic latanoprost, the authors showed improved adherence with the use of generic latanoprost compared to brand-name agents. Additionally, higher co-pays during the pregeneric period, lower copays during the postgeneric period and black race were also determined to be factors influencing postgeneric adherence.
Improved adherence noted in patients switching to a generic is an important consideration for our patients who are struggling to afford a brand name product. However, one should be cautioned that this study only addressed the refill rate of patients and their medications. No data is presented on the effectiveness of the generic and whether there was a potential increase in adherence secondary to increased “observation” by the health care professional after switching to the generic.
An interesting anecdotal finding was that there was a sizable group of patients (>7%) who simply stopped taking glaucoma medications altogether when generic latanoprost came to market. No identifiable reason was determined for why this group discontinued the use of their medications, but it is a cautionary note to clinicians to monitor patients who are potentially switched to a generic that they may discontinue all medications and may require more vigilant monitoring.
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Stein J, et al. Ophthalmology. Published online February 9, 2015. doi: http://dx.doi.org/10.1016/j.ophtha.2014.11.022
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