Real-world utilization patterns of cyclosporine ophthalmic emulsion 0.05% within managed care

Cyclosporine 0.05% ophthalmic emulsion (Restasis) is a treatment for dry eye disease. To examine patients' cyclosporine 0.05% utilization patterns by analyzing prescription fill data. A retrospective analysis with a large de-identified longitudinal patient database was conducted. Participants in the study had 1 prescription fill for cyclosporine 0.05% during a 3-month "enrollment" period from January 1 to March 31, 2004, and at least 1 refill within the following 12 months. Continuing patients had at least 1 cyclosporine 0.05% prescription fill, and new patients had none during 12 months prior to the "enrollment" period. Daily, monthly, and annual utilizations were assessed. 38,164 patients met the inclusion criteria. The majority of patients were female (82%), 50 years or older (77%), and new to therapy (59%). The FDA-recommended use is 2 vials daily (2 trays/month, each tray containing 32 vials) to receive the prescribed dosage of 1 drop in each eye twice daily. Prescription refill patterns demonstrated 73% of patients used 1 tray/month; similarly, 80% of the patients used 11 trays or less per year. Daily utilization differed between continuing and new patients. New patients had a bimodal use pattern. Over 30% were using > or = 1.75 vials/day and approximately 55% were using 0.25 to 1.25 vials/day. The majority of continuing patients (approximately 80%), however, used 0.25 to 1.25 vials/day. Most patients used about 1 vial per day, less than the labeled 2 per day. The cost to managed care for cyclosporine 0.05% ophthalmic emulsion may be less than anticipated. Key words: Cyclosporine 0.05% ophthalmic emulsion, longitudinal patient database, cost, utilization.