Fixed Doses Combinations Acting on Cardiovascular System - Utilization and Generic Competition
Z. Mitkova, M. Manova, S. Georgieva, G. Petrova
Advances in Research · pp. 1–14 · Published 27 Oct 2016
10.9734/AIR/2016/29264Abstract
Aims: To analyze the impact of introduction of new fixed dose combinations (FDCs) in the Positive drug list on both the reference price and the utilization of reimbursed cardiovascular (CV) medicines. Study Design: It is a retrospective and observational analysis of the changes in reimbursed fixed dose combinations (FDCs) acting on cardiovascular system (CVS). Place and Duration of Study: Medical University of Sofia, Faculty of Pharmacy for the period 2009-2013. Methodology: On total 18 INNs (international nonproprietary name) in different combinations belonging to 6 anatomic therapeutic chemical (ATC) groups (ACE-inhibitor and diuretic, Ca-antagonists and ACE-inhibitors, sartan and diuretics, Ca-antagonist and statin, two diuretics, b-blocker and diuretic); 60 dosage forms, and 104 trademarks were analyzed for changes in the prices and utilization after the inclusion in the Positive drug list (PDL). Results: The number of the new generic medicines included in PDL is highest for the group of ACE -inhibitors and diuretics, angiotensin receptor blockers (AT receptor blockers, ARBs, sartans) and diuretics. Many new generic molecules as FDCs enter the PDL, thus leading to decrease in the reference price, because of generic competition. The decrease is significant in the new therapeutic groups. The changes in utilization calculated as defined daily dose (DDD)/1000 inhabitants/day show higher utilization in 2013 for the groups of ACE inhibitors and diuretics and AT receptor blockers and diuretics (Enalapril/ Hydrochlorthiazide (HCTZ), Perindopril/ Indapamide, Valsartan/HCTZ, Losartan/ HCTZ). Conclusion: The study confirms that in Bulgaria the generic and therapeutic competition has increased during 2009-2013. It leads to significant price decrease and changes in the trends in utilization of the FDC in cardiology.
References (28)
- 1 European cardiovascular disease statistics
- 2 Combination Therapy Versus Monotherapy in Reducing Blood Pressure: Meta-analysis on 11,000 Participants from 42 Trials [DOI]
- 3 Hypertension management 2011: optimal combination therapy [DOI]
- 4 Mitigation of calcium channel blocker-related oedema in hypertension by antagonists of the renin–angiotensin system [DOI]
- 5 Fixed-Dose Combination Antidiabetic Therapy: Real-World Factors Associated with Prescribing Choices and Relationship with Patient Satisfaction and Compliance [DOI]
- 6 Effects of Monotherapy and Combination Therapy on Blood Pressure Control and Target Organ Damage: A Randomized Prospective Intervention Study in a Large Population of Hypertensive Patients [DOI]
- 7 A Multifactorial Trial Design to Assess Combination Therapy in Hypertension [DOI]
- 8 Strategies for combination therapy in hypertension [DOI]
- 9 Combination drug treatment of hypertension: Have we come full circle? [DOI]
- 10 Antihypertensive effectiveness of low-dose lisinopril-hydrochlorothiazide combination. A large multicenter study. Lisinopril-Hydrochlorothiazide Group [DOI]
- 11 Combination therapy with diuretics: An evolution of understanding [DOI]
- 12 Combination Therapy with Candesartan Cilexetil 32 mg and Hydrochlorothiazide 25 mg Provides the Full Additive Antihypertensive Effect of the Components [DOI]
- 13 Rationale for Combination Therapy as Initial Treatment for Hypertension [DOI]
- 14 Cardiovascular Risk Assessment of Bulgarian Urban Population: Cross-Sectional Study [DOI]
- 15 How do Compliance, Convenience, and Tolerability Affect Blood Pressure Goal Rates? [DOI]
- 16 Cost of outpatient hypertension pharmacotherapy: comparative study between Bulgaria and Serbia [DOI]
- 17 Combination of Converting Enzyme Inhibitor With Diuretic for the Treatment of Hypertension [DOI]
- 18 The effects of irbesartan added to hydrochlorothiazide for the treatment of hypertension in patients non-responsive to hydrochlorothiazide alone [DOI]
- 19 Newer approaches to antihypertensive therapy. Use of fixed-dose combination therapy [DOI]
- 20 Improving Blood Pressure Control Rates: Is There More We Can Do? [DOI]
- 21 Valsartan plus hydrochlorothiazide: a review of its use since its introduction [DOI]
- 22 Combination of converting enzyme inhibitor with diuretic for the treatment of hypertension [DOI]
- 23 Irbesartan and Hydrochlorothiazide Association in the Treatment of Hypertension [DOI]
- 24 Calcium-channel blockade (nitrendipine) in combination with ACE inhibition (captopril) in the treatment of mild to moderate hypertension [DOI]
- 25 The defined daily dose as a measure of drug consumption in South Africa. A preliminary study.
- 26 A multifactorial trial design to assess combination therapy in hypertension. Treatment with bisoprolol and hydrochlorothiazide [DOI]
- 27 The defined daily dose as a measure of drug consumption in South Africa
- 28 Cardiovascular Therapy: Evidence‐based Medicine, Questions and Answers. [DOI]
Cited by 2
Z. Mitkova, G. Petrova · Iranian journal of pharmaceutical research · 2021
Mboguilomouo Lisbeth Akebayeri · 2018
Related research
- A Review on Consumer Patterns and Behaviours’ Towards Generic Medicines — shares topic coverage
Article metrics
Real usage data collected on this platform.
17
Page views
0
PDF downloads
2
Outbound clicks
2
Citations
Views over time
Views by country
Approximate, from request IP at view time — not citizenship or institution. Countries with fewer than 5 views are grouped as "Other".
Traffic sources
Referring site, by host.
Views and downloads exclude known bots/crawlers. Citations combines this platform's own DOI-resolved index with each external source's own reported total — see Cited by above for individually listed citing works. Last refreshed 0 seconds ago.