Original articleMedical therapy cost considerations for glaucoma
Section snippets
Methods
All medications were ordered from a wholesaler and not from the manufacturer. The medication national drug codes (NDC number) and each lot number were recorded. The actual, not labeled, volume was determined for each bottle at 25 C. The bottles were held at approximately 135 degrees as the drops were collected, as described previously.3 After the drops ceased to flow, the bottle was inverted to 180 degrees to try to obtain every last complete drop. The entire content of each 2.5-ml bottle was
Results
Most products achieved the minimal volume on the label (that is, 5 ml, 10 ml, and so forth). Overfill needs to be considered when determining baseline costs, because some products contain less volume and some contain more volume than the stated label amount on each bottle.
The average number of drops per milliliter varied widely from 19.7 drops per milliliter (levobunolol) to 39.3 drops per milliliter for Rescula (Novartis; Table 1). The newer medications were more efficient in regard to number
Discussion
We had previously reported on the glaucoma medications on a cost per day basis.3 The number of drops per milliliter, the actual volume, and the cost per bottle are helpful in determining the daily treatment costs for patients with glaucoma. Using a general average (that is, 20 drops per milliliter) to estimate the number of drops per milliliter of a given ophthalmic medication is not accurate. This variability in overfill and drops per milliliter has been demonstrated by others.4, 5, 6, 7 Two
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