Regional variation and trends in prostaglandin analogue prescribing for glaucoma in England 2019-2024.
Robinson David Grant, Whitaker Angela
AI Summary
This study found significant regional variation and costly non-generic prostaglandin analogue prescribing for glaucoma in England. Standardizing cost-effective choices could yield substantial NHS savings.
Abstract
Background
Prescribing for glaucoma drops constitutes a large proportion of the NHS medicines budget for ophthalmology. NICE guidelines direct clinicians towards the prescription of a generic prostaglandin analogue (PGA) as a first-line topical hypotensive for lowering intraocular pressure. Between 2009 and 2018 the cost-effectivity of PGA prescribing at a national level in England was questionable. This study aimed to examine the variation and trends of PGA prescription at a regional level from 2019 to 2024.
Methods
Using an online open-access source, monthly data relating to General Practitioner prescription of latanoprost, bimatoprost, travoprost and tafluprost were collected. Data gathered related to PGA prescription activity from each of the individual Clinical Commissioning Groups (CCGs) in England. Descriptive statistics and choropleth maps were produced to display outcomes.
Results
Total PGA prescribing cost over 5 years was £166 M for 21.9 M prescriptions. A broad trend towards generic prescribing was identified. Branded and preservative free prescribing, in preference to a generic equivalent, resulted in an additional cost of approximately £54 M. Latanoprost was most readily prescribed in the South West and South East regions. Bimatoprost and travoprost were prescribed more in the North East and the East of England respectively.
Conclusions
Regional variation in PGA prescribing exists in England. Further investigation is required to determine the primary cause for the reported differences. Reducing variations so that prescribing clinicians are directed towards the most cost-effective PGA choice has the potential for considerable cost savings to NHS budgets.
Key Concepts7
The total cost for prostaglandin analogue (PGA) prescribing over 5 years (2019-2024) in England was £166 million for 21.9 million prescriptions.
A broad trend towards generic prostaglandin analogue (PGA) prescribing was identified in England between 2019 and 2024.
Branded and preservative-free prostaglandin analogue (PGA) prescribing, in preference to a generic equivalent, resulted in an additional cost of approximately £54 million in England between 2019 and 2024.
Latanoprost was most readily prescribed among prostaglandin analogues (PGAs) in the South West and South East regions of England between 2019 and 2024.
Bimatoprost was prescribed more among prostaglandin analogues (PGAs) in the North East of England between 2019 and 2024.
Travoprost was prescribed more among prostaglandin analogues (PGAs) in the East of England between 2019 and 2024.
This study collected monthly data relating to General Practitioner prescription of latanoprost, bimatoprost, travoprost, and tafluprost from individual Clinical Commissioning Groups (CCGs) in England using an online open-access source between 2019 and 2024.
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