Real-World Treatment Patterns Of Cyclosporine Ophthalmic Emulsion And Lifitegrast Ophthalmic Solution Among Patients With Dry Eye

Darrell E White,¹ Yang Zhao,² Abayomi Ogundele,² Nicole Fulcher,³ Annabel Acs,³ Laura Moore-Schiltz,³ Paul M Karpecki<sup>4

1</sup>Department of Ophthalmology, SkyVision Centers, Westlake, OH 44145, USA; ²Health Economics and Outcomes Research, Sun Pharmaceutical Industries, Princeton, NJ 08540, USA; ³Outcomes Research, IBM Watson Health, Cambridge, MA 02142, USA; ⁴Corneal Services and Advanced OSD Clinic, University of Pikeville Kentucky College of Optometry, Pikeville, KY 41501, USA

Correspondence: Yang Zhao
Health Economics and Outcomes Research, Sun Pharmaceutical Industries, Inc., 2 Independence Way, Princeton, NJ 08540, USA
Tel +1 609 720 8132
Email yang.zhao@sunpharma.com

Purpose: To assess adherence, non-persistence, discontinuation, and switching of topical cyclosporine ophthalmic emulsion 0.05% (CYC) and lifitegrast ophthalmic solution 5% (LIF) use in the real world among patients with dry eye disease (DED).
Design: Retrospective insurance claims study.
Methods: Adult patients with DED and ≥1 prescription claim for CYC or LIF (first claim = index date) in the IBM^® MarketScan^® databases from July 2016 to February 2018 were identified. Eligible patients had continuous medical and pharmacy benefits in the 12 months pre- and post-index periods, and no prior use of the index medication. The proportion of days covered (PDC), adherence, non-persistence, discontinuation, and switching were examined over the 12-month post-index period.
Results: This study included 6537 CYC and 3235 LIF patients. The adherence rate was 5.9% for CYC and 9.7% for LIF; the median PDC was 0.3 for both cohorts. Overall, 70.8% of CYC and 64.4% of LIF patients discontinued treatment with median days to discontinuation of 89 and 29, respectively. Non-persistence was 7.1% for CYC and 6.8% for LIF (median days to discontinuation: 89 and 105). In addition, 5.0% switched from CYC to LIF, and 9.6% switched from LIF to CYC over the post-index period.
Conclusion: Over 60% of DED patients discontinued treatment within 12 months of initiation; the median time to discontinuation was 3 months for CYC and 1 month for LIF. Although this analysis did not capture the reasons why patients discontinued treatment, the results demonstrate there likely exists a significant unmet need amongst DED patients.

Keywords: dry eye disease, adherence, persistence, cyclosporine ophthalmic emulsion, lifitegrast ophthalmic solution