OBJECTIVES: Several studies have shown that reducing the intraocular pressure (IOP) of patients with glaucoma to a target level ≤18 mmHg prevents further visual field deterioration. The objective of this analysis was to compare the IOP-lowering efficacy and the cost-effectiveness of fixed combinations of brimonidine/timolol and dorzolamide/timolol in 10 European countries. METHODS: Efficacy and safety of the two fixed combination products were based on pooled data from two head-to-head trials. Efficacy was measured as the percentage of patients reaching an IOP level ≤18 mmHg or ≤13 mmHg after 3 months of treatment. Discontinuation rates due to adverse events were also included in the model, and it was assumed that patients discontinuing treatment had an extra ophthalmologist visit. All drug costs were market prices inclusive of VAT, and ophthalmologist visit costs were priced using official tariffs. RESULTS: Clinical efficacy data showed that brimonidine/timolol was more effective than dorzolamide/timolol in terms of lowering patients’ IOP. The percentage of patients reaching IOP ≤13 mmHg was 32.65% for brimonidine/timolol and 13.95% for dorzolamide/timolol (p=.0359). 77.55% of brimonidine/timolol patients reached a target IOP ≤18 mmHg, and 60.47% of dorzolamide/timolol patients did (p=.0756). Three months’ health care costs for patients treated with brimonidine/timolol were comparable to those of dorzolamide/timolol treatment in the 10 studied countries. Brimonidine/timolol was less costly and more effective in Italy, Spain, and Norway, whereas it was more effective and slightly more costly in Germany, the United Kingdom, Denmark, Sweden, the Netherlands, Portugal and France. In these countries, the incremental cost per patient reaching a target IOP ≤18 mmHg ranged from £0.32 (United Kingdom) to €26.66 (the Netherlands). For IOP ≤13 mm Hg the range was £0.29 (United Kingdom) to €24.36 (the Netherlands). CONCLUSIONS: Brimonidine/timolol is effective in terms of lowering IOP and is a cost-effective treatment strategy for patients with glaucoma.