Cost and clinical effectiveness of fixed-dose combination therapies in the treatment of glaucoma patients: a systematic review

Background. Primary open-angle glaucoma (POAG) is a chronic, progressive eye condition causing optic nerve damage and irreversible vision loss by increasing intraocular pressure (IOP). Therapy primarily aimed at reducing IOP to prevent disease progression. Pharmacoeconomic evaluation of fixed-dose combinations (FDCs) has attracted growing interest in recent years as a strategy to enhance both treatment efficacy and accessibility. Objective: To review the cost and clinical effectiveness for FDCs of travoprost/timolol (TT) and latanoprost/timolol (LT) for POAG treatment. Material and methods. A systematic literature review was conducted using PubMed/MEDLINE, Web of Science, ScienceDirect, and Google Scholar databases. The sampling included studies evaluating FDCs of TT and LT in terms of its cost and clinical effectiveness, as well as cost-effectiveness and cost-utility ratios. Results. TT-FCD proved to be more cost-effective than LT-FDC in several European countries and the Philippines, resulting in lower long-term costs and slowing the progression of vision loss. Conversely, in China identified LT-FDC was more cost-effective due to lower daily costs. Both FDC options improved patient adherence to treatment due to their simplified administration. Conclusion. TT-FCD may be a more favorable treatment option for POAG in certain regions, considering its pharmacoeconomic and clinical advantages. However, treatment selection should be individualized based on regional healthcare dynamics, medicine pricing, and patient access to medicines.

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