The impact of the genericization of Pfizer’s Xalatan at the end of March 2011 is reflected in changes to both current and anticipated ophthalmologist prescribing behavior for primary open angle glaucoma (POAG) patients. Among pharmacologically-treated patients, two-thirds are currently prescribed prostaglandin analogs, specifically Allergan’s Lumigan, Alcon’s Travatan Z, and Pfizer’s Xalatan, with the remaining use being split between fixed combination products (Allergan’s Combigan), beta blockers (Alcon’s Betoptic S), alpha agonists (Allergan’s Alphagan P), and carbonic anhydrase inhibitors (Alcon’s Azopt). Surveyed ophthalmologists report recent increased prescribing of Lumigan and Travatan Z in response to diminished insurance coverage for Xalatan in anticipation of generic latanoprost. Interestingly, almost one-half of ophthalmologists report frequent patient requests for a generic product reflecting the strong influence of cost within this patient population. While respondents anticipate continued use of prostaglandin analogs for the majority of their patients with POAG, Lumigan 0.01% is anticipated to pull ahead of Lumigan 0.03% over the next six months due to higher satisfaction with the low concentration formulation’s efficacy and tolerability profile.
While surgery is typically seen as a third or later line option for the treatment of POAG, general ophthalmologists and glaucoma specialists differ significantly in terms of when to use surgery and what types of surgical options (e.g. laser trabeculoplasty, trabeculectomy, aqueous shunts, nonpenetrating surgery, etc) are appropriate. In fact, the appropriate use of surgery remains a predominant area of discussion within the market.
Ophthalmologists report a high unmet need for products with unique mechanisms of action [other than intraocular pressure (IOP) lowering], neuroprotective properties, and a lower cost to patients. While awareness of products in development for the treatment of POAG is low, especially among general ophthalmologists, interest was highest for QLT’s sustained release, punctual plug delivery system of latanoprost among the six therapies in development that were profiled in the research. Unaided and aided awareness of aqueous shunts in development was low although glaucoma specialists were significantly more aware of aided brands, including the iStent shunt and the Eyepass shunt, compared to general ophthalmologists.
TreatmentTrends®: Glaucoma is an annual syndicated report series that provides a comprehensive view of the current and expected future management of glaucoma, with a focus on POAG, based on primary research. The survey was fielded in mid-March 2011 with 102 U.S. ophthalmologists, 45% of whom classify themselves as glaucoma specialists. TreatmentTrends: Glaucoma covers the use of drug classes and agents for the treatment of glaucoma, as well as attitudes and perceptions toward these products, advantages and disadvantages, ideal patient types, barriers to growth, and expected future use. In addition, respondents were queried about their awareness of and interest in products in development for the treatment of POAG.
BioTrends Research Group, LLC
Decision Resources, Inc.
View drug information on Alphagan; Lumigan; Travatan.