Strategy
The statistics for lack of adherence to a medical regimen by patients with chronic medical conditions are surprisingly low, even when those conditions are potentially life-threatening. This is especially the case where, until there is a catastrophic health event, these medical conditions are either asymptomatic or have very minor symptoms. We aim to produce a formulation which, in itself, greatly increases patient compliance to medication, with specific focus on a disease in which patient adherence to their medication regimen is known to be poor.
In glaucoma, approximately half of all patients fail to comply with their regimen of medication and discontinue all topical ocular hypotensive therapy medication after 6 months. This figure drops still further after one year when less than 50% of patients are adhering to their regimen of medication.
A review of twenty-nine original quantitative studies in English, French, German and Dutch showed proportions of patients who deviated from their prescribed medication regimen as high as 80%, and in a landmark study of approximately 14,000 patients, after 12 months only an astonishing 10% of patients were taking their medication without any gaps.
This is particularly problematic for glaucoma, since progression of the disease and any resultant damage to the optic nerve is permanent and irreversible. Non-compliance by patients to their medication regimen therefore commonly results in disease progression and unnecessary additional therapy for the patients, with its associated costs and risks. From the point of view of healthcare services this also results in an increased economic burden in terms of clinic loads and surgical waiting lists.
Rivia plans to give clinicians a tool to use to ensure adherence by their patients, by combining glaucoma medication, often not used because early-stage glaucoma itself is virtually asymptomatic, with a topical drug for a condition which is highly symptomatic, such as presbyopia. There is a high overlap between the patient groups for glaucoma and presbyopia, since both conditions tend to show onset in the same, aging populations. Those patients with presbyopia will be reminded to take their combination drugs on a daily basis, for the fundamental reason that without the medication, they will simply not be able to see clearly.
In addition to increasing compliance, this particular formulation will solve a longstanding problem for ophthalmologists who are continually faced with the dilemma of presbyopic patients with glaucomatous progression. Numerous articles and papers concur that due to the anatomical and functional reasons for loss of visual acuity in glaucoma patients, the premium/multifocal IOLs normally used for treating presbyopia are contraindicated in patients with a likelihood of disease progression in glaucoma. Many surgeons will therefore only use premium/multifocal IOLs in patients with mild, stable and controlled glaucoma, no disc or visual field loss, and no signs of glaucoma progression. For any other patients with glaucoma, Rivia’s combination formula is the ideal solution to this problem.