In 2016, 57.1 million Americans were enrolled in Medicare and 42.9 million (75%) of them were also enrolled in Medicare Part D, which helps enrollees pay for self-administered prescription drugs. That same year, glaucoma medications accounted for more Medicare Part D spending than any other drugs used to treat eye diseases, and, of all classes of medications used to treat glaucoma, prostaglandin analogs (PGAs) were associated with the greatest cost.

A recent analysis published in the Journal of Glaucoma found that PGAs pose an ongoing financial burden and barrier to patients, many of whom are retirement age or older and rely on a fixed income that is insufficient to pay for the costs associated with treatment; a survey of glaucoma patients showed that 41% had difficulty paying for their medications.

In an effort to examine the prices, price variations and trends of the PGAs purchased in the United States through Medicare Part D, a team of researchers conducted a retrospective, cross-sectional study of ODs and MDs in all 50 states and DC, using Medicare data from 2013 to 2016 for both brand name and generic PGAs.

The team found a substantial variation in drug prices, which they note are increasing yearly, when purchased by Medicare Part D enrollees across the United States and within each state. The 2016 nationwide prices of 30-day supplies and varations within each state are shown below:

Drug30-day Supply CostVariation Within State
Travatan Z$171.36±19.44$17.23
Zioptan $162.75±13.22$9.48

The authors found less price variation within each state compared with variations across the entire country.

“Physicians should be cognizant of this price variation for these expensive and chronically used drugs and should educate patients to optimize their Part D supplemental plan,” the study concludes.

Priluck AZ, Havens SJ. Variation in prostaglandin analog prices paid for through Medicare Part D. J Glaucoma. October 17, 2018. [Epub ahead of print].