Journal article

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


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Author list: Brian Godman a,b,c,d, Holly McCabee
, Trudy D Leong f
, Debjani Muellerg,h, Antony P. Martin i,j, Iris Hoxhak
,
Julius C. Mwita l
, Godfrey Mutashambara Rwegerera m, Amos Masselen
, Juliana de Oliveira Costa o,p,q,
Renata Cristina Rezende Macedo do Nascimento a,r, Livia Lovato Pires de Lemos o,p, Konstantin Tachkov s
,
Petya Milushewas
, Okwen Patrickt,u, Loveline Lum Nibat,v, Ott Laiusw, Israel Sefah x
, Suhaj Abdulsalim y
,
Fatemeh Soleymani z,aa, Anastasia N Guantaibb, Loice Achieng cc, Margaret Olukabb, Arianit Jakupidd,
Konstantīns Logvissee, Mohamed Azmi Hassali d
, Dan Kibuule ff, Francis Kalemeera ff, Mwangana Mubitaff
,
Joseph Fadare gg,hh, Olayinka O. Ogunleye ii,jj, Zikria Saleem kk, Shazhad Hussainll, Tomasz Bochenek mm,
Ileana Mardare nn, Alian A. Alrasheedy oo, Jurij Furstpp, Dominik Tomekqq, Vanda Markovic-Pekovic rr,
Enos M. Rampamba b,ss, Abubakr Alfadl oo,tt, Adefolarin A Amuuu, Zinhle Matsebulavv,
Thuy Nguyen Thi Phuong ww, Binh Nguyen Thanhww, Aubrey Chichonyi Kalungia xx, Trust Zaranyika yy,
Nyasha Masuka zz, Ioana D. Olaru aaa,bbb, Janney Waleccc, Ruaraidh Hill ddd, Amanj Kurdi a,eee, Angela Timoneya,
fff, Stephen Campbell ggg,hhh and Johanna C. Meyer

Publication year: 2020

Journal: EXPERT REVIEW OF PHARMACOECONOMICS & OUTCOMES RESEARCH

Journal acronym: Expert Rev Pharmacoecon Outcomes Res

Volume number: 20

Issue number: 1

Start page: 1

End page: 26

Number of pages: 26

ISSN: 473-7167

eISSN: 1744-8379



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.


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Last updated on 2025-10-11 at 11:23