常用局部眼用非甾体抗炎药的填充水平、成本比较和排出力要求。

Fill levels, cost comparisons, and expulsion force requirements of commonly used topical ophthalmic nonsteroidal anti-inflammatory drugs.

机构信息

From the Dean McGee Eye Institute, University of Oklahoma, Oklahoma City, Oklahoma (Heath, McDonald, Murphy, Riaz); Oklahoma School of Science and Mathematics, Oklahoma City, Oklahoma (S.V. Shah, S. Shah); Hudson College of Public Health, University of Oklahoma, Oklahoma City, Oklahoma (Ding).

出版信息

J Cataract Refract Surg. 2023 Jul 1;49(7):747-753. doi: 10.1097/j.jcrs.0000000000001177.

DOI:10.1097/j.jcrs.0000000000001177

PMID:36853852

Abstract

PURPOSE

To determine volume fill levels, estimated costs, and force expulsion requirements per bottle of topical ophthalmic nonsteroidal anti-inflammatory drugs (NSAIDs) commonly perioperatively in the United States.

SETTING

Tertiary care academic medical center.

DESIGN

Prospective laboratory investigation.

METHODS

8 commercially available NSAIDs (3 branded, 5 generic) were tested: branded bromfenac 0.07%, generic bromfenac 0.09%, diclofenac 0.1%, flurbiprofen 0.03%, generic ketorolac 0.5%, branded ketorolac 0.5%, ketorolac 0.47%, and branded nepafenac 0.3%. 10 bottles of each medication were tested, with an additional bottle tested for expulsion force requirements. A double-blinded method was used to measure the actual bottle fill volume and number of drops per bottle. The total cost per drop was calculated using published cash prices. Force requirements were measured using a customized force gauge apparatus. Formulations were compared using the Kruskal-Wallis test, followed by pairwise comparisons with the Dwass, Steel, Critchlow-Fligner Method.

RESULTS

2 branded NSAIDs (bromfenac and nepafenac) had slightly lower-than-sticker volumes while generics other than ketorolac had higher-than-sticker volumes. Diclofenac and branded bromfenac had the highest and lowest adjusted number of drops respectively. Generic bromfenac and generic ketorolac had the highest and lowest adjusted volume compared with sticker volume respectively. Branded bromfenac was the most expensive medication, while generic diclofenac was the least expensive. Force expulsion requirements varied significantly among generic and branded NSAIDs.

CONCLUSIONS

Volume fill levels, patient-incurred costs, and expulsion force requirements per bottle of topical NSAID medications vary significantly. Surgeons may wish to consider these factors when deciding how best to use these medications perioperatively.

摘要

目的

确定美国围手术期常用的局部眼科非甾体抗炎药（NSAIDs）每瓶的容量填充水平、估计成本和挤出力要求。

背景

三级保健学术医疗中心。

设计

前瞻性实验室研究。

方法

测试了 8 种市售 NSAIDs（3 种品牌，5 种通用）：品牌溴芬酸 0.07%、通用溴芬酸 0.09%、双氯芬酸 0.1%、氟比洛芬 0.03%、通用酮咯酸 0.5%、品牌酮咯酸 0.5%、酮咯酸 0.47%和品牌萘普生 0.3%。每种药物测试了 10 瓶，另外还测试了一瓶挤出力要求。采用双盲法测量实际瓶填充体积和每瓶滴数。使用公布的现金价格计算每滴的总成本。使用定制的力计装置测量力要求。使用 Kruskal-Wallis 检验比较配方，然后使用 Dwass、Steel、Critchlow-Fligner 方法进行两两比较。

结果

2 种品牌 NSAIDs（溴芬酸和萘普生）的体积略低于标签，而非酮咯酸的通用药物体积高于标签。双氯芬酸和品牌溴芬酸分别具有最高和最低的调整滴数。与标签体积相比，通用溴芬酸和通用酮咯酸具有最高和最低的调整体积。品牌溴芬酸是最昂贵的药物，而通用双氯芬酸是最便宜的。通用和品牌 NSAIDs 的挤出力要求差异显著。