Dry Eye Treatment Gaps Persist, Whereas Comorbid DED Does Not Affect Glaucoma Adherence

Why It Matters

Low prescription uptake and early drop‑off in DED limit clinical outcomes and increase reliance on over‑the‑counter products, while steady glaucoma adherence suggests existing therapies are tolerable even with eye‑surface disease.

Key Takeaways

• Only 12.4% of newly diagnosed Medicare patients received DED prescriptions.
• First‑line DED therapy starts on average 285 days after diagnosis.
• Nearly half of DED patients discontinue initial treatment without a second line.
• Latanoprostene bunod adherence (PDC 0.73) unchanged by comorbid DED.
• 44.5% of glaucoma patients stop LBN; most restart later.

Pulse Analysis

Dry eye disease remains under‑treated in the Medicare population, with prescription uptake lagging far behind diagnosis. The Humana data show that most patients rely on over‑the‑counter lubricants, delaying evidence‑based therapies such as cyclosporine for nearly ten months. This gap not only prolongs symptom burden but also raises downstream costs from increased office visits and potential complications like corneal damage. Payers and providers must consider educational outreach and streamlined prescribing pathways to close the treatment lag.

Glaucoma management, by comparison, appears resilient to the presence of comorbid DED. Real‑world claims for latanoprostene bunod demonstrate a mean proportion of days covered of 0.73, with adherence rates indistinguishable between patients with and without dry eye. The drug’s once‑daily dosing and favorable safety profile likely mitigate the irritation that could otherwise deter use. For clinicians, this evidence supports confidence in maintaining standard glaucoma regimens even when patients report ocular surface discomfort.

The divergent patterns highlight a broader managed‑care challenge: aligning medication access with disease severity across ophthalmic conditions. While glaucoma therapies achieve acceptable adherence, the DED landscape calls for targeted interventions—such as prior‑authorization incentives for prescription drops, pharmacist‑led counseling, and outcome‑based contracts—to shift patients from OTC reliance to clinically proven treatments. Future research should quantify the cost offsets of improved DED adherence, informing policy decisions that balance patient convenience with long‑term ocular health.