Reinitiation rates after discontinuation of glaucoma eye drop therapy: evidence from Japanese Health Insurance Claims

Glaucoma is the leading cause of blindness in Japan, yet persistence with topical intraocular pressure–lowering therapy is poor and many patients discontinue treatment. What happens after discontinuation—whether patients reinitiate therapy—has been little studied. Using a nationwide Japanese health insurance claims database, we analyzed outpatient records from January 2005 to June 2024 to quantify reinitiation after discontinuation of glaucoma eyedrop therapy. Discontinuation events were identified, and annual reinitiation rates were calculated for each of the five years thereafter; associations with patient and product characteristics were examined using multivariable logistic regression. Among 111,438 patients who discontinued therapy, 82,215 remained observable through the end of the first year following discontinuation; of these, 42.3% reinitiated treatment within that year, and the 5-year cumulative reinitiation probability was 52.5%. Younger age and discontinuation early after treatment initiation were associated with a lower likelihood of resuming therapy, and products requiring more frequent daily instillation were likewise linked to lower reinitiation. These findings indicate that prescription records are consistent with short cycles of treatment interruption and resumption being common in routine practice, and they may help clinicians prioritize follow-up and select regimens that support treatment continuity and return to care.