OBJECTIVES: Prostaglandin analogs (PGAs) are recommended as first-line therapy to lower intraocular pressure among glaucoma patients. Patients with lower rates of persistence and compliance could potentially have a higher risk of developing progressive visual loss. This study aims to compare persistence and compliance on latanoprostene bunod, latanoprost, latanoprost generic and bimatoprost, within a 12-month analysis period.

METHODS: Anonymized patient-level data, from the Ontario Drug Benefit (ODB) database, was used to index patients on their first claim for specific products during a 12-month period. Patients were followed for up to 12 months. Persistence was measured from index to first observed significant gap in therapy (days supplied of claim with an allowable grace period of 90 days) and output as a Kaplan-Meier curve. Compliance was measured as a Medication Possession Ratio (MPR) using a fixed denominator (365 days) and compared using a Fisher’s Exact test.

RESULTS: From a cohort of 13,262 patients (latanoprostene bunod n = 662, latanoprost n = 1,041, latanoprost generic n = 4,811, bimatoprost n = 6,748), those indexing on latanoprostene bunod demonstrate significantly higher persistence at 12 months (65.11%, p<0.001) compared to latanoprost generic (54.73%). 12-month persistence among patients initiating on latanoprostene bunod (65.11%) is similar to those initiating on latanoprost (61.19%, p=0.055), and bimatoprost (63.17%, p=0.268). Latanoprostene bunod has a significantly higher proportion of patients with an MPR of >80% at 12 months (80.1%) compared to latanoprost (71.4%, p=0.005) and latanoprost generic (63.7%, p=<0.001). 12-month compliance among patients initiating on latanoprostene bunod (80.1%) is similar to those initiating bimatoprost (79.3, p=0.568).

CONCLUSIONS: In the Canadian population studied, persistence and compliance on latanoprostene bunod was better compared to both latanoprost and latanoprost generic. Patients initiating Bimatoprost demonstrate a similar persistence and compliance as those initiating latanoprostene bunod. Strategies that support improved persistence and compliance with PGAs could prevent vision loss among patients.