Assessments of Variations seen in intraocular pressure and its cost effectiveness of drugs used among patients diagnosed as Primary open angle glaucoma at tertiary care hospital

OBJECTIVE: The present study evaluated the variations seen in intraocular pressure and cost of therapy for primary open angle glaucoma. METHOD: Proforma was designed factoring patients’ demographical profile RESULT: A total of 100 prescriptions of patients suffering from glaucoma were analyzed. Maximum cases (36%) belonged of age group 40 to 50 years with a gender ratio (Male/female) of 2.3. 82% had bilateral glaucoma. The patients aged more than 40 years had high intraocular pressure ranged 25-45 mm Hg. Total average cost of therapy per day per prescription was found to be Rs 7.52. Conclusion: The present study showed high variation among patient suffering from primary open angle glaucoma. High average cost of therapy per day is matter of concern. Introduction Primary open-angle glaucoma is described as optic nerve damage from multiple possible causes that is chronic and progresses over time, with a loss of optic nerve fibers that is characteristic of the disease. In addition to the loss of optic nerve fibers, primary open-angle glaucoma is characterized by open anterior chamber angles, visual field abnormalities, and intraocular pressure that is too high for the continued health of the eye. Primary open-angle glaucoma exhibits cupping (depression) and atrophy of the optic disc (the front surface of the optic nerve, which is seen in the back of the eye), in the absence of other known causes of glaucomatous disease (1,2 ) The prevalence of glaucoma is increasing worldwide, In India there are approximately 11.2 million persons aged 40 years and older with glaucoma. Primary open angle glaucoma (POAG) is estimated to affect about 6.48million. Globally an estimated 60.5 million people were (2.65% of the global population over 40) suffered from glaucoma in 2010. Of these an estimated 44.7 million had primary open angle glaucoma (POAG) . The prevalence of glaucoma is expected to reach 79.6 million in 2020, impacting all countries although the largest increases are expected to be in china and India. This together will represent nearly 40% of case worldwide. Globally the number of people with POAG is estimated to reach 58.6 million by 2020, More than 4.5 million currently were bilaterally blind from POAG in 2010, a number that is forecasted to rise to 5.9 million by 2020(1,3). Causes of raised intraocular pressure Normally the aqueous humor plays an important role in nutrient delivery and waste disposal for the cells. It is produced by the ciliary body epithelium and drains out through the trabecular meshwork at the anterior chamber angle. When this flow is disrupted the pressure within the eye builds up (4, 5). This disruption can occur in two ways:• Blockage at the drainage at the trabecular meshwork (in open angle glaucoma) • Narrowing of the angle of drainage (in angle closure glaucoma Materials & Methods: 1. This is a prospective study conducted in Out Patient Department of Ophtalmology, MGM Hospital, Kamothe, Navi Mumbai. In this study, Those Patients visited our OPD were included. Once the consultation by the ophthalmologist was over, the prescriptions were copied, and the patients were interviewed. The data includes name, age, sex, indations (diagnosis), drug name, and dose, route of administration, frequency and duration of treatment. 2. After noting down the required parameters prescriptions were returned to the patients and Data were analyzed for variation of IOP and cost of drug used in treatment of primary open angle glaucoma. 3. The study was conducted between sep 2011 to Aug 2012 4. Cost of the drug was taken from the CIMS, Indian pharmaceutical Guide and MGM pharmacy Cost indicators: In this study the following economic indicators were used 1. Average cost of drug used in OPD cases 2. Per day cost of individual drug Observation and Results In present study, 100 prescriptions of glaucoma patients have been analyzed, out of which 69% were male and 31% were female patients respectively. Maximum patients (54%) were in age group of 40 -60 yrs, out of, which 36% were male and 18% were female patient. (Table 1) Table 1: Age and sex distribution of patients Age Male Female Total (%)