PURPOSE: Perfluorohexyloctane ophthalmic solution (PFHO; MIEBO), the first and only prescription eye drop for dry eye disease (DED) directly targeting tear evaporation, was introduced in the United States in September 2023. This study describes clinical and demographic characteristics of PFHO early adopters and refill rates after initial prescriptions.

METHODS: Adult patients (≥18 years) newly initiating PFHO from September 1-November 30, 2023, were identified from the IQVIA Longitudinal Prescription Claims. Eligible patients had linkage to the IQVIA Professional Fee Claims database and a 12-month pre-initiation period ("baseline") for sample characterization. For patients initiating treatment in September or October 2023, refill rates within 60 days were assessed and descriptively compared to a cohort initiating cyclosporine ophthalmic solution 0.05% (CsA, branded or generic).

RESULTS: In total, 7209 patients (79.9% female; mean age, 60.6 years) initiated PFHO. PFHO prescribers were mostly optometrists (54.7%) and ophthalmologists (43.1%). Nearly 100 ocular surface disease ICD-10-CM codes were used to understand DED recording for claims. Only 38.5% of patients had a claim indicative of DED in the baseline period. Common codes indicated aqueous deficient (28.7%), evaporative (11.3%), or inflammatory (16.7%) DED, reflecting its multifactorial nature. Almost half of patients (46.6%) used DED medication during baseline. CsA 0.05% (21.8%) and lifitegrast (17.1%) were most commonly used. The 60-day refill rate for PFHO was 67.3% versus 26.2% for CsA 0.05% initiators (n=75,871).

CONCLUSIONS: Overall, early adopters of PFHO were consistent with the epidemiology of DED. DED may be under-coded in claims, given that only <40% of patients had ded claims. the higher refill rate for pfho versus csa 0.05 suggests a higher degree of patient satisfaction and clinical benefit with this new first-in-class treatment for ded.>