Topical medications are a mainstay first-line treatment for elevated IOP and prevention of optic nerve damage, but it is well documented in the literature — and well known by every glaucoma specialist — that the barriers to consistent drop use are significant. With the introduction of Simple Drops (Imprimis Pharmaceuticals), help has arrived. As the name suggests, the goal is to ease the burden of complicated glaucoma medication regimens to foster better patient compliance.

Benefits to Patients and Practice Staff

As I do with any new product that becomes available, I’m studying Simple Drops in a group of my own patients. More than 40 patients who switched to Simple Drops report that the reduction in the number of medication bottles and dosing times to track has significantly improved the quality of their daily lives.

For the majority of patients, average IOP has remained the same or decreased. The drops have been very well tolerated, and only two patients experienced an allergic reaction, the same reaction they experienced with the active ingredient in a different, branded combination formulation. A number of patients reported an improvement in their dry eye symptoms, and I’ve noted corresponding corneal improvements on clinical exam. My study is ongoing, and I expect to present more detailed results at an upcoming national meeting.

Simple Drops have simplified life for our practice staff, too. The staff fields far fewer calls from patients who are confused about which drops to use when. Also, because drops are ordered online and sent directly to patients on a recurring basis, they know the costs up front, and our staff doesn’t need to interact with pharmacies on their behalf. Simple Drops aren’t covered by Medicare or other insurance providers, so patients pay out of pocket. However, the cost is typically similar to or less than the cost of a copay if insurance were used.

We refer to these benefits as the “Clarity of Cs,” because it provides clarity for our staff as well as patients and their family members regarding cost, consumption, and compliance.

What About Issues with Compounding Pharmacies?

I fully support the advantages of branded glaucoma medications and will continue to prescribe them, up to the point where the treatment burden threatens a patient’s willingness or ability to comply. At that point, I see Simple Drops as the sensible alternative. The company has assured doctors that its formulations meet or exceed U.S. Pharmacopeia requirements, and the compounding pharmacies it utilizes are accredited by the Pharmacy Compounding Accreditation Board. It carries both of the FDA-sanctioned 503B and 503A designations. Although I’m typically skeptical about compounded medications, I’m comfortable with the level of quality control and ingredient sourcing surrounding Simple Drops. Additionally, the delivery vehicle utilized by these formulations is polaxamer 407 based, which has been shown to increase residence time and bioavailability while acting as a surfactant for the combination formulations. This means the compounded drugs within each formula will remain compounded, delivering consistent, appropriate dosage with every drop dispensed.

A Valuable Tool

So far, the products are proving to be of value in my practice. To cite one example, Simple Drops allowed one of my patients with advanced glaucoma to avoid the surgery we had scheduled for her. Although her original drop regimen was working, she became increasingly worried about her ability to continue the regimen for a long period of time.

Not wanting to risk uncontrolled IOP, we agreed surgery was best. However, we tried Simple Drops first, one bottle in the morning and one at night. After several weeks, she felt certain she could continue to handle that, so we canceled surgery. I expect to see more success stories as more patients switch to Simple Drops. GP

Dr. Singh is in practice at The Eye Centers of Racine and Kenosha in Wisconsin.