What Is Happening To Glaucoma Prescribing Now That We Have Slt And Migs

New advances in the treatment of glaucoma including Selective Laser Trabeculoplasty (SLT) and Minimally Invasive Glaucoma Surgery (MIGS) have reduced the need for topical IOP lowering treatment in an increasing number of patients with Primary Open Angle Glaucoma. Topical glaucoma therapies may cause a significant burden to patients due to induced ocular surface disease and the inconvenience of polypharmacy. We report trends in primary care glaucoma prescribing over a 2 year period.

National prescribing dataset for the National Health Service (NHS), United Kingdom

A retrospective review of all prescribing for glaucoma in primary care in the United Kingdom was undertaken using data supplied by GPrX. Prescribing data was recorded for 23 months between September 2020 and August 2022 including classes of treatments used, brands of treatments prescribed, cost of all prescriptions issued, number of packs issued per prescription and the location of prescriptions. The data was subsequently analysed to identify trends over time and regional prescribing variation.

A total of £239,738,677.00 was spent on glaucoma prescribing in primary care during the study period with an average spend of £9,589,547.07 per month. The most prescribed treatment was LatanoBimatoprost and Timolol combination) which accounted for 23% of all glaucoma prescribing. Glaucoma prescribing accounts for 46% of all primary care Ophthalmology prescribing costs. A statistically significant downward trend was observed in the number and cost of prescriptions over time. An increase in the proportion of preservative-free treatments was seen although this was not significant. Significant differences in regional and national prescribing data were identified. 

Glaucoma prescribing represents a significant financial cost to the NHS. Non-medical treatments for glaucoma may be contributing to a reduction in outpatient prescribing for glaucoma in primary care.