Ocular lubricants: Utilisation analysis using MedicineInsight data
Page last updated: 13 July 2021
Drug utilisation sub-committee (DUSC)
February 2021
Abstract
Purpose
PBAC requested a review of the utilisation of ocular lubricants at its July 2020 meeting. The analyses in this report are based on general practice data from MedicineInsight.
Data Source / methodology
This study is a descriptive analysis of MedicineInsight data exploring the prescribing of ocular lubricants in general practice. It uses de-identified patient data from the clinical information systems (CIS) of between 423–441 participating general practices and 1.67 million to 1.96 million patients (depending upon study year). The study covered the period between 1 January 2015 to 31 December 2019, with a one year look back period for analyses of initiation.
Key Findings
- Consistent with the patterns seen in the PBS dispensing analysis, the percentage of MedicineInsight patients prescribed:
- an ocular lubricant decreased from 1.31% in 2015 to 1.06% in 2019;
- a preservative containing (PC) ocular lubricant decreased from 0.97% (16,310 patients) in 2015 to 0.64% (12,309 patients) in 2019; and
- a preservative free (PF) ocular lubricant increased from 0.40% (6,718 patients) in 2015 to 0.47% (8,965 patients) in 2019.
- The largest groups of MedicineInsight patients dispensed an ocular lubricant per year are females (55%) and males (27%) aged 65+ years.
- There was very little private prescribing of ocular lubricants among MedicineInsight patients, less than < 0.1% of all eligible MedicineInsight patients and less than 8.0% of all patients prescribed an ocular lubricant. Given many of these formulations can be purchased cheaply over the counter, this suggests that patients who are not concession card holders are unlikely to visit their GP for a prescription for these medicines.
- The prevalence of dry eye among all regularly attending MedicineInsight patients was estimated to be 2.2%. When extrapolated to MBS data, this suggests that between 416,907 and 526,620 Australians who visit their GP during the year will have dry eye.
- Dry eye was recorded in approximately half of patients prescribed any ocular lubricant, a PC ocular lubricant, a PF ocular lubricant or sodium hyaluronate. Please note that information about the reason for prescribing ocular lubricants may be included in GP progress notes which are not collected by MedicineInsight for privacy reasons.
- A significantly larger proportion of patients prescribed a PF ocular lubricant had a record of an autoimmune diseases or blepharitis/Meibomian gland dysfunction than among patients prescribed a PC ocular lubricant.
- Over the study period, the number of patients started on a PF ocular lubricant without any record of a prior PC ocular lubricant prescription increased. Among regularly attending patients in 2015–16, 3,340 were started on a PF ocular lubricant and 71.0% of these had no previous record of having been prescribed a PC ocular lubricant. Among, regularly attending patients in 2018–19, 5,460 patients were started on a PF ocular lubricant and 74.9% had no record of previous PC ocular lubricant prescriptions.
- Among patients newly started on a PF ocular lubricant, more than 70% of patients who had previously used a PC ocular lubricant, and more than half of patients without a prior PC ocular lubricant prescription had a record of at least one condition associated with the development of dry eye syndrome. This may be because patients with a prior prescription of PC ocular lubricants have been managed by their GP for a longer period and may have a more complete record of their condition.
- Very few MedicineInsight patients (0.05%) were prescribed both a PC ocular lubricant and a PF ocular lubricant at least once during 2019.
Full Report
Note: An analysis on the utilisation of ocular lubricants for dry eye syndrome was also done using PBS data and is available here.
