REAL-WORLD UTILIZATION PATTERNS OF CYCLOSPORINE OPHTHALMIC EMULSION 0.05% WITHIN MANAGED CARE
Main Article Content
Keywords
Cyclosporine 0.05%, ophthalmic emulsion, longitudinal patient database, cost, utilization
Abstract
Background
Cyclosporine 0.05% ophthalmic emulsion (Restasisâ ) is a treatment for dry eye disease.
Objectives
To examine patients' cyclosporine 0.05% utilization patterns by analyzing prescription fill data.
Methods
A retrospective analysis with a large de-identified longitudinal patient database was conducted. Participants in the study had 1 prescription fill for cyclosporine 0.05% during a 3-month "enrollment" period from January 1 to March 31, 2004, and at least 1 refill within the following 12 months. Continuing patients had at least 1 cyclosporine 0.05% prescription fill, and new patients had none during 12 months prior to the "enrollment" period. Daily, monthly, and annual utilizations were assessed.
Results
38,164 patients met the inclusion criteria. The majority of patients were female (82%), 50 years or older (77%), and new to therapy (59%). The FDA-recommended use is 2 vials daily (2 trays/month, each tray containing 32 vials) to receive the prescribed dosage of 1 drop in each eye twice daily. Prescription refill patterns demonstrated 73% of patients used 1 tray/month; similarly, 80% of the patients used 11 trays or less per year. Daily utilization differed between continuing and new patients. New patients had a bimodal use pattern. Over 30% were using ?1.75 vials/day and approximately 55% were using 0.25 to 1.25 vials/day. The majority of continuing patients (approximately 80%), however, used 0.25 to 1.25 vials/day.
Conclusions
Most patients used about 1 vial per day, less than the labeled 2 per day. The cost to managed care for cyclosporine 0.05% ophthalmic emulsion may be less than anticipated
References
2. Pflugfelder SC. Anti- inflammatory therapy for dry eye. Am J Ophthalmol 2004;137:337-42.
3. Sall K, Stevenson OD, Mundorf TK, Reis BL. Two multicenter, randomized studies of the efficacy and safety of cyclosporine ophthalmic emulsion in moderate to severe dry eye disease. CsA Phase 3 Study Group. Ophthalmology 2000;107:631-9.
4. Stevenson D, Tauber J, Reis BL. Efficacy and safety of cyclosporin A ophthalmic emulsion in the treatment of moderate-to-severe dry eye disease: a dose- ranging, randomized trial. The Cyclosporin A Phase 2 Study Group. Ophthalmology 2000;107:967-74.
5. Stonecipher K, Perry HD, Gross RH, Kerney DL. The impact of topical cyclosporine A emulsion 0.05% on the outcomes of patients with keratoconj unctivitissicca. Curr Med Res Opin 2005;21:1057 -63.
6. Barber LD, Pflugfelder SC, Tauber J, Foulks GN. Phase III safety evaluation of cyclosporine 0.1% ophthalmic emulsion administered twice daily to dry eye disease patients for up to 3 years. Ophthalmology 2005;112:1790-4.
7. Brignole F, Pisella PJ, De Saint Jean M, Goldschild M, Goguel A, Baudouin C. Flow cytometric analysis of inflammatory markers in KCS: 6-month treatment with topical cyclosporin A. Invest Ophthalmol Vis Sci 2001;42:90-5.
8. Kunert KS, Tisdale AS, Stern ME, Smith JA, Gipson IK. Analysis of topical cyclosporine treatment of patients with dry eye syndrome: effect on conjunctival lymphocytes. Arch Ophthalmol 2000;118:1489- 96.
9. Kunert KS, Tisdale AS, Gipson IK. Goblet cell numbers and epithelial proliferation in the conjunctiva of patients with dry eye syndrome treated with cyclosporine. Arch Ophthalmol 2002;120:330-7. Erratum in: Arch Ophthalmol 2002;120:1099.
10. Turner K, Pflugfelder SC, Ji Z, Feuer WJ, Stern M, Reis BL. Interleukin -6 levels in the conjunctival epithelium of patients with dry eye disease treated with cyclosporine ophthalmic emulsion. Cornea 2000;19:492-6.
11. Solomon A, Dursun D, Liu Z, Xie Y, Macri A, Pflugfelder SC. Pro- and anti-inflammatory forms of interleukin-1 in the tear fluid and conjunctiva of patients with dry-eye disease. Invest Ophthalmol Vis Sci 2001;42:2283-92.
12. Perry HD, Doshi- Carnevale S, Donnenfeld ED, Solomon R, Biser SA, Bloom AH. Efficacy of commercially available topical cyclosporine A 0.05% in the treatment of meibomian gland dysfunction. Cornea 2006;25:171-5.
13. Rubin M, Rao SN. Efficacy of topical cyclosporin 0.05% in the treatment of posterior blepharitis. J Ocul Pharmacol Ther 2006;22:47-53.
14. Salib GM, McDonald MB, Smolek M. Safety and efficacy of cyclosporine 0.05% drops versus unpreserved artificial tears in dry- eye patients having laser in situ keratomileusis. J Cataract Refract Surg 2006;32:772 -8.
15. Akpek EK, Dart JK, Watson S, et al. A randomized trial of topical cyclosporin 0.05% in topical steroid-resistant atopic keratoconjunctivitis. Ophthalmology 2004;111:476-82.
16. Hom MM. Use of cyclosporine 0.05% ophthalmic emulsion for contact lens-intolerant patients. Eye Contact Lens 2006;32:109-11.
17. Rao SN. Treatment of herpes simplex virus stromal keratitis unresponsive to topical prednisolone 1% with topical cyclosporine
0.05%. Am J Ophthalmol 2006;141:771-2.
18. Restasis prescribing information. Accessed at http://www.restasisprofessional.com/; (April 10,2006).
Article Sidebar
Article Details
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
All articles published in JPTCP are licensed under Copyright Creative Commons Attribution-NonCommercial 4.0 International License.