OBJECTIVE: Various pharmaceutical cost options have been developed by multiple companies such as GoodRx, Amazon Pharmacy, Mark Cuban Cost Plus Drugs (CPD), Health Warehouse, and Local Retail Pharmacies (LRP) to curb the cost of prescription medications prices that patients are having to bear. Vascular surgeons provide long-term continuity of care to patients with vascular disease who often require long-term medical management. This study sought to compare the different pharmaceutical options available for the most prescribed medications by vascular surgeons to their patients and to understand which of them are the most cost-effective.
METHODS: The Medicare Part D catalog and vascular surgical literature were evaluated to identify which medications are most prescribed by vascular surgeons. The average price per tablet being paid by patients was identified using the Agency for Healthcare and Research database. The prices per tablet for each of the above pharmaceutical companies were found using online catalogs or coupons. The prices were then compared using Analysis of Variance (ANOVA) and t-tests.
RESULTS: All four pharmaceutical cost options provide medication cost savings to patients compared to retail pharmacy costs. ANOVA showed that there were statistically significant differences amongst the different pharmaceutical cost options (F 15.44>2.36, P<.001). Mark Cuban CPD provided the most significant cost advantage over the other pharmaceutical options (p<0.01). On a national scale, medications prescribed by vascular surgeons through Mark Cuban CPD could provide a 52% cost reduction to patients with vascular disease with a potential annual savings of over $3 billion dollars for the selected medications.
CONCLUSIONS: Cost Plus Drugs shows a strong potential for cost-savings for patients commonly prescribed medications by vascular surgeons. As a specialty which provides long-term care and establishes long-term relationships with its patients, vascular surgeons have the unique ability to impact their overall health in a meaningful way by limiting the financial burdens associated with vascular-based medication acquisition and utilization.

The management of cancer is predicated on the availability and affordability of anticancer therapies, which may be either curative or noncurative.
The primary aims of the study were to evaluate (i) the formulary availability of licensed antineoplastic medicines across Europe; (ii) patient out-of-pocket costs for the medications and (iii) the actual availability of the medication for a patient with a valid prescription.
The survey tool was based on the previous ESMO studies that addressed the availability and accessibility of opioids for the management of cancer pain. A total of 185 field reporters from 49 countries were invited to participate. The preliminary set of data was posted on the ESMO website for open peer-review, and amendments have been incorporated into the final report.
There are substantial differences in the formulary availability, out-of-pocket costs and actual availability for many anticancer medicines. The most profound lack of availability is in countries with lower levels of economic development, particularly in Eastern Europe, and these are largely related to the cost of targeted agents approved in the last 10 years. Discrepancies are less profound among medications on the WHO model essential medicines list (EML) for cancer and in curative settings. However, medicine shortages also affect WHO EML medicines, with relevant therapeutic implications for many patients.
The cost and affordability of anticancer treatments with recent market approval is the major factor contributing to inequity of access to anticancer medications. This is especially true with regards to new medications used in the management of EGFR- or ALK-mutated non-small-cell lung cancer, metastatic melanoma, metastatic renal cell cancer, RAS/RAF wild-type metastatic colorectal cancer, HER2 overexpressed breast cancer and castration-resistant metastatic prostate cancer.

OBJECTIVE: To elucidate compliance rates among glaucoma patients in a tertiary healthcare center, reasons for noncompliance and response-based-solutions to improve compl iance in the same cohort.
METHODS: In the Glauco-Jung study, a cross-sectional descriptive epidemiological one, information was obtained from 500 patients from 1st January, 2014 to 30th June, 2014. Patients were intercepted at entry point where they get their intraocular pressure (IOP) checked, wherein they were asked to fill an exhaustive questionnaire. At the same setting, they were also asked to demonstrate how they (or their relatives or helpers) instill eyedrops, following which any irregularities were brought to notice and corrected. Finally, they were also asked any suggestions to improve compliance to medications. Noncompliance rates were determined based on the number of patients who did not instill anti-glaucoma medications as per prescribed dosage or frequency schedule. Noncompliance rates were then evaluated by the Chi-square test for any association with distributions based on various parameters.
RESULTS: In case of a positive association, correlation coefficient was further calculated to know the strength of this association. No association was observed in distributions based on diet, associated co-morbidities, daily dosage frequency and side-effects experienced by patients. Positive association was noted in distributions based on age, sex, duration of treatment, social structure and number of medications (p < 0.05); but correlation coefficients were very weak (c < 0.3). Cost of medications not only had positive association but also had a very strong correlation coefficient (c = 0.9188), proving that cost of medications had a modest bearing on compliance rates.
CONCLUSIONS: The Glauco-Jung study concluded that besides availability of medications at reasonable cost, simplification of treatment regimen and interactive health education appear to be the most important factors for improving compliance so that patients do not feel guilty or inadequate because they have problems while administering their eyedrops. How to cite this article: Gupta VS, Sethi H, Naik M. Strategies to Improve Glaucoma Compliance Based on Cross-Sectional Response-Based Data in a Tertiary Healthcare Center: The Glauco-Jung Study. J Curr Glaucoma Pract 2015;9(2):38-46.