BACKGROUND: Perfluorohexyloctane ophthalmic solution (PFHO), 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 claims database study describes clinical and demographic characteristics of PFHO early adopters and refill rates after initial prescriptions.

METHOD: Adult patients (=18 years) newly initiating PFHO from September 1-November 30, 2023, were identified from the IQVIA Longitudinal Prescription Claims database. Eligible patients had linkage to the IQVIA Professional Fee Claims database and a 12-month pre-initiation period ("baseline") for sample characterization. Descriptive statistics were produced for demographics, index prescription characteristics, and baseline clinical characteristics including previous medication use and DED diagnosis. 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 and 75,871 initiated CsA (80.4% female; mean age, 66.6 years). Index prescriptions of PFHO and CsA were received primarily from optometrists (54.7% and 42.9%, respectively) and ophthalmologists (43.1% and 47.5%). Overall, 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. Baseline DED medication use was higher among PFHO (46.6%) than CsA (8.1%) patients, suggesting potential dissatisfaction with prior therapy. A higher proportion of PFHO patients (93.1%) than CsA patients (56.9%) received an index prescription of =30 days' supply. The 60-day refill rate (among patients with =30 days' supply of their index prescription and only one claim on index date) was 70.7% for PFHO versus 43.4% for CsA.

CONCLUSION: DED appears under-recorded in the claims, as almost two-thirds of PFHO and CsA patients received the index prescription despite not having a recorded DED diagnosis. The higher refill rate for PFHO versus CsA 0.05% suggests a higher degree of patient satisfaction with this new, first-in-class treatment for DED.