Response to Anderson et al.

Sir,

We would like to thank Dr Anderson and colleagues for the time and effort they made to respond to our article.¹ We are in hearty agreement with them that systemic side effects are an important consideration in β blocker therapy.^{2, 3} This issue was considered extensively in our model and is noted in the 4th paragraph under ‘Markov model: medical aspects’ on the 2nd page of the article. To account for persistency rates, we used numerous published studies that included discontinuations for reasons of systemic side effects. The additional costs of these side effects were accounted for by the inclusion of the extra visit to change medications. We did not include costs for the primary care physician because of lack of evidence in the literature that such visits occur, even occasionally, because of the acute systemic side effects from β blockers. We believe this happens probably because ophthalmologists are generally adept at avoiding patients who might have acute, serious, systemic problems with topical β blockers.

Log in or create a free account to read this content

Gain free access to this article, as well as selected content from this journal and more on nature.com

Access through your institution

or

Sign in or create an account

Continue with Google

Continue with ORCiD