A comparative study on the efficacy and cost-effectiveness of latanoprost and timolol in glaucoma

Background: Glaucoma is a chronic, progressive optic neuropathy which leads to optic nerve damage and loss of visual function. Elevated intraocular pressure (IOP) is the most important and only modifiable risk factor. Ocular hypotensive agents have the potential to lower the IOP and preserve vision. Aims and Objectives: The aims of the study were to compare topical latanoprost eye drop and topical timolol eye drop as appropriate and cost-effective management of primary open-angle glaucoma (POAG). Materials and Methods: A total of 70 newly diagnosed patients POAG who fulfilled the inclusion/exclusion criteria were enrolled and randomized into two groups. The first group L-Group was prescribed topical latanoprost 0.005% eye drop once daily, whereas the second group T-Group was prescribed topical timolol 0.5% eye drop twice a day. Final reduction in IOP was recorded after 3 months of treatment in both the groups. The cost-effectiveness was calculated as the cost of the drug per mmHg fall in IOP. Results: In our study, the IOP lowering efficacy of latanoprost was found to be superior to timolol. In the latanoprost group, the mean reduction in IOP from baseline to final visit was 10.13 mmHg, whereas only 5.84 mmHg in the timolol group. The average cost-effective ratio was found to be Rs. 32.4/ mmHg and Rs. 6.16/mmHg for latanoprost and timolol, respectively. Hence, timolol proved to be more cost effective as compare to latanoprost. Conclusion: Although latanoprost was found to be superior to timolol in reducing the IOP, yet because of its high cost the treatment should be started with timolol and latanoprost should only be used as an add-on therapy in cases not able to achieve target IOP by timolol monotherapy or in whom timolol is contraindicated.