OBJECTIVES: To assess patient satisfaction and economic implications associated with a new formulation of brimonidine 0.2% ophthalmic solution. METHODS: Randomized, controlled trials were conducted in 743 patients to evaluate the original formulation vs. the new formulation. The new formulation reduced the concentration of the active ingredient from 0.2% to 0.15% and replaced the preservative, benzalkonium chloride (BAK), with Purite. Patient outcomes assessed were satisfaction and comfort level with the product. The economic evaluation model estimated the annual cost per patient including pharmacy and medical office visits (including those that may occur due to adverse events.) RESULTS: More patients were satisfied with the new formulation (83%) than the original (75%) (p<0.05). Eighty-five percent of patients reported the new formulation was comfortable vs. 79% for the original. Clinical efficacy (as measured by IOP reduction) was not different between the groups. Approximately 90% of the new formulation patients had no reported ocular allergy (OA) vs. 84% of the patients using the original formulation (p<0.05). Incidence of OA was the primary cost driver in comparing the two formulations, as patients who develop an ocular allergy require additional resources associated with OA. The economic model estimated the cost of an OA patient was $200 more or 36% higher per year than for an OA free patient, which results in higher overall treatment costs associated with the original formulation. CONCLUSIONS: Patients receiving the new reformulated 0.15% brimonidine, rated their treatment satisfaction and comfort level higher than patients on the original formulation while experiencing the same level of efficacy. The estimated cost savings for ocular allergy-free patients would have a positive impact on overall treatment costs.