What is the Economic Impact of Fixed-combination Medications?

A substantial portion of the costs associated with glaucoma for healthcare systems and individuals at all stages of severity is medication-related,¹ which gives rise to interest in what effect fixed-combination medications may have on those costs. In one analysis,² which focused on countries outside the United States, Hommer concluded that existing data suggest the use of fixed combinations is generally associated with reduced costs, but the issue is complicated by cost differences between countries and the difficulty of assessing both direct and indirect costs.

According to ophthalmologists in the United States, accurately determining the impact of fixed combinations on patient and societal costs is just as, if not more, difficult given the healthcare delivery system. “The answer is different from region to region, and at the most basic level, it depends on the pharmacy and the insurance company and which medications are on which tier at any given time,” says L. Jay Katz, MD, director of the Wills Eye Institute Glaucoma Service and professor of Ophthalmology at Jefferson Medical College in Philadelphia.

Nathan Radcliffe, MD, director of the Glaucoma Service and clinical assistant professor at New York University Langone Ophthalmology Associates, concurs and adds, “It’s interesting, too, that even though Cosopt is available in a generic formulation, it is sometimes placed on a higher tier than most other generic eyedrops and therefore may not be any less expensive than the brand. Even so, if we globally consider costs, there’s nothing more cost-effective than preventing blindness, and these medications are powerful at lowering the pressure and treating glaucoma. We’re better off when we use them as part of an aggressive strategy to lower IOP while at the same time helping our patients be as compliant as they can be in order to decrease the burden of vision loss from glaucoma.”

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