Fixed dose drug combinations – are they pharmacoeconomically sound? Findings and implications especially for lower- and middle-income countries

Brian Godman(Karolinska University Hospital), Holly McCabe(University of Strathclyde), Trudy Leong(Department of Health), Debjani Mueller(Steve Biko Hospital), Antony P. Martin(University of Liverpool), Iris Hoxha(University of Medicine Tirana), Julius Chacha Mwita(University of Botswana), Godfrey Mutashambara Rwegerera(University of Botswana), Amos Massele(University of Botswana), Juliana de Oliveira Costa(Universidade Federal de Minas Gerais), Renata Cristina Rezende Macedo do Nascimento(Universidade Federal de Ouro Preto), Lívia Lovato Pires de Lemos(Universidade Federal de Minas Gerais), Konstantin Tachkov(Medical University of Sofia), Petya Milushewa(Medical University of Sofia), Patrick Okwen(University of Bamenda), Loveline Lum Niba(University of Bamenda), Ott Laius, Israel Abebrese Sefah(Ghana Health Service), Suhaj Abdulsalim(Qassim University), Fatemeh Soleymani(Tehran University of Medical Sciences), Anastasia N Guantai(University of Nairobi), Loice Achieng(University of Nairobi), Margaret Oluka(University of Nairobi), Arianit Jakupi(University for Business and Technology), Konstantīns Logviss(Riga Stradiņš University), Mohamed Azmi Hassali(Universiti Sains Malaysia), Dan Kibuule(University of Namibia), Francis Kalemeera(University of Namibia), Mwangana Mubita(University of Namibia), Joseph Fadare(Ekiti State University), Olayinka O. Ogunleye(Lagos State University), Zikria Saleem(University of Lahore), Shazhad Hussain(National Institute of Health), Tomasz Bochenek(Jagiellonian University), Ileana Mardare(Carol Davila University of Medicine and Pharmacy), Alian A. Alrasheedy(Qassim University), Jurij Fürst(Health Insurance Institute of Slovenia), D Tomek(Slovak Medical University), Vanda Marković‐Peković(University of Banja Luka), Enos M Rampamba(Sefako Makgatho Health Sciences University), Abubakr Alfadl(Qassim University), Adefolarin A. Amu(University of Eswatini), Zinhle Matsebula(Razi Hospital), Thuy Nguyen Thi Phuong(Hanoi University of Pharmacy), Binh Nguyen Thanh(Hanoi University of Pharmacy), Aubrey Chichonyi Kalungia(University of Zambia), Trust Zaranyika(University of Zimbabwe), Nyasha Masuka, Ioana D. Olaru(London School of Hygiene & Tropical Medicine), Janney Wale, Ruaraidh Hill(University of Liverpool), Amanj Kurdi(Hawler Medical University), Angela Timoney(NHS Lothian), Stephen Campbell(Manchester Academic Health Science Centre), Johanna C. Meyer(Sefako Makgatho Health Sciences University)
Expert Review of Pharmacoeconomics & Outcomes Research
January 2, 2020
Cited by 90Open Access
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Abstract

: 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.


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