OBJECTIVES: To compare the effectiveness and associated costs of Travatan (prostaglandin) and Xalacom (prostaglandin + â-blocker) as first-line treatments for glaucoma, according to the United Kingdom General Practitioner Research Database (UK-GPRD). METHODS: Patients diagnosed with ocular hypertension or glaucoma treated with a topical treatment, surgery or by laser were identified. Patients confirmed to have been prescribed first line Travatan or Xalacom monotherapy were selected. Treatment failure was defined as a prescription change (adding or removing a topical treatment). Time to treatment failure was compared using an adjusted Cox model. Drugs, visits and glaucoma procedures consumed during a specified 1 year period were entered into a cost minimization analysis, viewed from a NHS perspective. RESULTS: 56,612 patients were identified and 39,808 had received at least one topical prescription for glaucoma; 176 received Xalacom and 639 got Travatan as first-line treatments for glaucoma. No significant difference was found between the characteristics of the two patient groups. Patients were 70.2 years old at diagnosis, on average, and 48.2% were male. At one year, 35.8 % of the patients failed with Xalacom, and 27.1% failed with Travatan (p=0.024). The hazard ratio for treatment failure was 0.749 and less with Travatan (p=0.04) than with Xalacom, after adjusting for age, gender, and comorbidities. Xalacom regimens were statistically (p<0.001) more costly (£328 p.a.) than Travatan regimens (£216 p.a.). CONCLUSION: According to UK-GPRD information, Travatan dominated Xalacom as first-line treatment for glaucoma patients. Patients remained under Travatan treatment longer and at a lower cost.