The aim of our study is to explore the national trend in prescriptions for glaucoma and ocular hypertension in France between 2014 and 2019.
Glaucoma is an important cause of irreversible blindness worldwide and seems to be increasing. Risk factors for glaucoma have been identified and the only modifiable factor is intraocular pressure. Several options are available, of which medical treatment is first in line.
Primary open-angle glaucoma, with a normal appearance of the iridocorneal angle, is the predominant form of glaucoma. The term ocular hypertension is commonly used to define an intraocular pressure of more than 21 mmHg without clinical glaucomatous optic nerve damage or visual field deficit.
It is recommended to treat patients with ocular hypertension and at high risk of progression to glaucoma.
This study is a retrospective descriptive study based on prescription data from the Primary Health Insurance Fund databases.
All patients with a social security number who received one or more glaucoma/ocular hypertension prescription items between 2014 and 2019 were identified. Figures for 2020 are not yet available.
Demographic characteristics from Common Classification of Medical Acts information and from National Institute of Statistics and Economic Studies were analyzed.
The data treatment was carried out using the R version 3.6.2.software from the available databases of Information Systems Medicalization Program and with the input of the Primary Health Insurance Fund.
Glaucoma drugs used in this study were classified into the following categories:
Prostaglandin analogs, carbonic anhydrase inhibitors, alpha-receptor agonists, beta-receptor antagonists, cholinergic agonists and fixed combination drops containing either timolol or brinzolamide. Excluded were Pilocarpine and Iopinide 0.5% and 1%
Our results suggest an increase in the number of patients treated with glaucoma drugs, not simply explained by demographic growth.
There is also an evolution in drug prescription habits, both in the type of molecule used and in the use of fixed associations.
We also note the increasing use of Selective Laser Trabeculoplasty, a new tool in the therapeutic arsenal.
In the same time period, demographic characteristics remain stable, age and sex distribution for each year remained constant.
In addition, the phenomenon of lack of therapeutic compliance, which we tried to explore, remains stable.
This study seeks to update the epidemiological statistics available in France on the treatment of ocular hypertension and glaucoma, a real problem of public health both in terms of resulting morbidity and economic cost
Our study suggests on the one hand that prescribing practices have evolved over the period studied and, on the other hand, that the number of patients treated for glaucoma or ocular hypertension has increased faster than the growth of the French population over the same period. These findings concord with trends observed in previous studies.
