Fixed dose drug combinations – are they pharmacoeconomically sound? Findings and implications especially for lower- and middle-income countries
Year: 2020
Type: article
Abstract: Introduction: There are positive aspects regarding the prescribing of fixed dose combinations (FDCs) versus prescribing the medicines separately.However, these have to be balanced against concerns including increased costs and their irrationality in some cases.Consequently, there is a need to review their value among lower-and middle-income countries (LMICs) which have the greatest prevalence of both infectious and noninfectious diseases and issues of affordability.Areas covered: Review of potential advantages, disadvantages, cost-effectiveness, and availability of FDCs in high priority disease areas in LMICs and possible initiatives to enhance the prescribing of valued FDCs and limit their use where there are concerns with their value.Expert commentary: FDCs are valued across LMICs.Advantages include potentially improved response rates, reduced adverse reactions, increased adherence rates, and reduced costs.Concerns include increased chances of drug:drug interactions, reduced effectiveness, potential for imprecise diagnoses and higher unjustified prices.Overall certain FDCs including those for malaria, tuberculosis, and hypertension are valued and listed in the country's essential medicine lists, with initiatives needed to enhance their prescribing where currently low prescribing rates.Proposed initiatives include robust clinical and economic data to address the current paucity of pharmacoeconomic data.Irrational FDCs persists in some countries which are being addressed.
Authors: Brian Godman, Holly McCabe, Trudy D Leong, Debjani Mueller, Antony P. Martin, Iris Hoxha, Julius C. Mwita, Godfrey Mutashambara Rwegerera, Amos Massele, Juliana de Oliveira Costa, Renata Cristina Rezende Macedo do Nascimento, Livia Lovato Pires de Lemos, Konstantin Tachkov, Petya Milushewa, Okwen Patrick, Loveline Lum Niba, Ott Laius, Israel Sefah, Suhaj Abdulsalim, Fatemeh Soleymani, Anastasia N Guantai, Loice Achieng, Margaret Oluka, Arianit Jakupi, Konstantīns Logviss, Mohamed Azmi Hassali, Dan Kibuule, Francis Kalemeera, Mwangana Mubita, Joseph Fadare, Olayinka O. Ogunleye, Zikria Saleem, Shazhad Hussain, Tomasz Bochenek, Ileana Mardare, Alian A. Alrasheedy, Jurij Furst, Dominik Tomek, Vanda Markovic-Pekovic, Enos M. Rampamba, Abubakr Alfadl, Adefolarin A Amu, Zinhle Matsebula, Thuy Nguyen Thi Phuong, Binh Nguyen Thanh, Aubrey Chichonyi Kalungia, Trust Zaranyika, Nyasha Masuka, Ioana D. Olaru, Janney Wale, Ruaraidh Hill, Amanj Kurdi, Angela Timoney, Stephen Campbell, Johanna C. Meyer
Institutions: Karolinska University Hospital, Universiti Sains Malaysia, University of Strathclyde, Sefako Makgatho Health Sciences University, Karolinska Institutet, Department of Health, Johannesburg Hospital, Steve Biko Hospital, University of Pretoria, University of Liverpool, University of Medicine Tirana, University of Botswana, Universidade Federal de Minas Gerais, UNSW Sydney, Centre for Big Data Research in Health, Universidade Federal de Ouro Preto, Medical University of Sofia, Effective Basic Services for Africa, Adelaide University, The University of Adelaide, University of Bamenda, Ghana Health Service, Qassim University, Pharmaceutical Management and Economics Research Center, Tehran University of Medical Sciences, University of Nairobi, University for Business and Technology, Riga Stradiņš University, University of Namibia, Ekiti State University, Lagos State University, Lagos University Teaching Hospital, Lagos State University Teaching Hospital, University of Lahore, National Institute of Health, Jagiellonian University, Carol Davila University of Medicine and Pharmacy, Health Insurance Institute of Slovenia, Slovak Medical University, University of Banja Luka, Federal Ministry of Health, Hanoi University of Pharmacy, University of Zambia, University of Zimbabwe, London School of Hygiene & Tropical Medicine, Biomedical Research and Training Institute, Hawler Medical University, NHS Lothian, University of Manchester, NIHR Greater Manchester Patient Safety Translational Research Centre
Language: English
Subfield: Economics and Econometrics
Domain: Social Sciences
Open Access status: hybrid
OpenAlex ID: W3010268564