Daily cost of beta-adrenergic blocker therapy
W. C. Stewart, C. Sine, E. Cate, G. E. Minno and H. H. Hunt
Pharmaceutical Research Corporation, Charleston, SC, USA.
OBJECTIVE: To evaluate the daily cost of beta-blocker therapy among
commercially available products. METHODS: Ten different beta-adrenergic
blocker preparations, each in 10-mL bottles (except Timoptic-XE [Merck
brand of timolol maleate gel-forming solution], which was in a 5-mL
bottle), were acquired from a local pharmacy. Each of 10 subjects dispensed
10 drops from each bottle onto an analytical scale. The mean drop volume
for each preparation was then calculated. The fill volume of each bottle
and the amount of each medicine that was wasted upon dispensing also were
determined. Additionally, 60 pharmacies in the United States were randomly
chosen to determine the average cost of each preparation studied. Based on
all data obtained, an average daily cost of each medicine was calculated.
RESULTS: The generic formulation of timolol maleate (Falcon) ($0.55) and
Betimol (Ciba Vision Ophthalmics brand of timolol hemihydrate) ($0.57)
demonstrated the lowest cost per day of therapy. In contrast, Betoptic-S
(Alcon brand of betaxolol hydrochloride) ($1.60) and Betagan (Allergan
brand of levobunonol hydrochloride) ($1.35) had the highest daily cost of
therapy. Ocupress (Otsuka America brand of carteolol hydrochloride) had the
smallest drop volume (31 microL) and Timoptic-XE had the highest (49
microL). Most preparations were close to their stated bottle fill volume.
The amount of wasted medicine varied and was least with Ocupress (27%) and
greatest with Betoptic-S (54%). The mean pharmacy price for a 10-mL bottle
was lowest for OptiPranolol (Bausch & Lomb brand of metipranolol)
($25.51) and Betimol ($28.28); Betoptic-S ($44.80) and Betagan ($43.67)
were the most expensive. CONCLUSION: Although all commercially available
beta-adrenergic blockers effectively lower intraocular pressure, one
differential factor between medicines is cost, which may be influenced by
the price at the pharmacy, volume of medication per bottle, drop size, and
medicine wastage.
