Dynamic view on affordability of fixed-dose combination antihypertensive drug therapy

Song Hee Hong, Junling Wang, Jun Tang

Research output: Contribution to journalArticle

12 Citations (Scopus)

Abstract

Background The use of fixed-dose combinations (FDCs) has been increasing since the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommended using ≥2 drugs as the first-line drug therapy for patients with stage 2 hypertension. FDCs simplify the drug therapy regimen and reportedly lower the drug therapy cost compared with the free combination (FC) of 2 single-agent drugs. This study hypothesized that the affordability of FDCs over FCs would change over time depending on the availability of generic single-agent drugs. Methods This study used the 2009 Medical Expenditure Panel Survey. Antihypertensive drugs were identified based on the Food and Drug Administration national drug directory. Based on the 2 databases, regression models were run to predict average monthly drug cost as well as out-of-pocket cost for each prescription along with their 95% confidence intervals (CIs). Results Overall, FDCs (n = 26) had average monthly drug costs similar to respective FCs when FCs were not generically available. However, when FCs were generically available, FDCs (n = 11) had average drugs costs much higher than their respective FCs. For example, Lotrel as an FDC had an average monthly drug cost of $115.97 (95% CI = $96.59-$135.36), whereas its counterpart FC had an average monthly drug cost of $21.00 (95% CI = $18.23-$23. 79). Conclusions The cost advantage of FDCs over FCs was reversed when FCs were generically available. The finding of this study informs patients, health-care providers, and drug plans of the importance of making dynamic decisions on preferred drug therapy options depending on the availability of generic drugs.

Original languageEnglish (US)
Pages (from-to)879-887
Number of pages9
JournalAmerican journal of hypertension
Volume26
Issue number7
DOIs
StatePublished - Jul 1 2013

Fingerprint

Drug Costs
Combination Drug Therapy
Antihypertensive Agents
Pharmaceutical Preparations
Confidence Intervals
Health Expenditures
Drug Therapy
Hypertension
Generic Drugs
Directories
United States Food and Drug Administration
Health Personnel
Prescriptions
Decision Making
Patient Care
Databases
Costs and Cost Analysis

All Science Journal Classification (ASJC) codes

  • Internal Medicine

Cite this

Dynamic view on affordability of fixed-dose combination antihypertensive drug therapy. / Hong, Song Hee; Wang, Junling; Tang, Jun.

In: American journal of hypertension, Vol. 26, No. 7, 01.07.2013, p. 879-887.

Research output: Contribution to journalArticle

@article{53b00aa3f4fc452c97440240e13175bc,
title = "Dynamic view on affordability of fixed-dose combination antihypertensive drug therapy",
abstract = "Background The use of fixed-dose combinations (FDCs) has been increasing since the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommended using ≥2 drugs as the first-line drug therapy for patients with stage 2 hypertension. FDCs simplify the drug therapy regimen and reportedly lower the drug therapy cost compared with the free combination (FC) of 2 single-agent drugs. This study hypothesized that the affordability of FDCs over FCs would change over time depending on the availability of generic single-agent drugs. Methods This study used the 2009 Medical Expenditure Panel Survey. Antihypertensive drugs were identified based on the Food and Drug Administration national drug directory. Based on the 2 databases, regression models were run to predict average monthly drug cost as well as out-of-pocket cost for each prescription along with their 95{\%} confidence intervals (CIs). Results Overall, FDCs (n = 26) had average monthly drug costs similar to respective FCs when FCs were not generically available. However, when FCs were generically available, FDCs (n = 11) had average drugs costs much higher than their respective FCs. For example, Lotrel as an FDC had an average monthly drug cost of $115.97 (95{\%} CI = $96.59-$135.36), whereas its counterpart FC had an average monthly drug cost of $21.00 (95{\%} CI = $18.23-$23. 79). Conclusions The cost advantage of FDCs over FCs was reversed when FCs were generically available. The finding of this study informs patients, health-care providers, and drug plans of the importance of making dynamic decisions on preferred drug therapy options depending on the availability of generic drugs.",
author = "Hong, {Song Hee} and Junling Wang and Jun Tang",
year = "2013",
month = "7",
day = "1",
doi = "10.1093/ajh/hpt035",
language = "English (US)",
volume = "26",
pages = "879--887",
journal = "American Journal of Hypertension",
issn = "0895-7061",
publisher = "Oxford University Press",
number = "7",

}

TY - JOUR

T1 - Dynamic view on affordability of fixed-dose combination antihypertensive drug therapy

AU - Hong, Song Hee

AU - Wang, Junling

AU - Tang, Jun

PY - 2013/7/1

Y1 - 2013/7/1

N2 - Background The use of fixed-dose combinations (FDCs) has been increasing since the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommended using ≥2 drugs as the first-line drug therapy for patients with stage 2 hypertension. FDCs simplify the drug therapy regimen and reportedly lower the drug therapy cost compared with the free combination (FC) of 2 single-agent drugs. This study hypothesized that the affordability of FDCs over FCs would change over time depending on the availability of generic single-agent drugs. Methods This study used the 2009 Medical Expenditure Panel Survey. Antihypertensive drugs were identified based on the Food and Drug Administration national drug directory. Based on the 2 databases, regression models were run to predict average monthly drug cost as well as out-of-pocket cost for each prescription along with their 95% confidence intervals (CIs). Results Overall, FDCs (n = 26) had average monthly drug costs similar to respective FCs when FCs were not generically available. However, when FCs were generically available, FDCs (n = 11) had average drugs costs much higher than their respective FCs. For example, Lotrel as an FDC had an average monthly drug cost of $115.97 (95% CI = $96.59-$135.36), whereas its counterpart FC had an average monthly drug cost of $21.00 (95% CI = $18.23-$23. 79). Conclusions The cost advantage of FDCs over FCs was reversed when FCs were generically available. The finding of this study informs patients, health-care providers, and drug plans of the importance of making dynamic decisions on preferred drug therapy options depending on the availability of generic drugs.

AB - Background The use of fixed-dose combinations (FDCs) has been increasing since the Seventh Report of the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure recommended using ≥2 drugs as the first-line drug therapy for patients with stage 2 hypertension. FDCs simplify the drug therapy regimen and reportedly lower the drug therapy cost compared with the free combination (FC) of 2 single-agent drugs. This study hypothesized that the affordability of FDCs over FCs would change over time depending on the availability of generic single-agent drugs. Methods This study used the 2009 Medical Expenditure Panel Survey. Antihypertensive drugs were identified based on the Food and Drug Administration national drug directory. Based on the 2 databases, regression models were run to predict average monthly drug cost as well as out-of-pocket cost for each prescription along with their 95% confidence intervals (CIs). Results Overall, FDCs (n = 26) had average monthly drug costs similar to respective FCs when FCs were not generically available. However, when FCs were generically available, FDCs (n = 11) had average drugs costs much higher than their respective FCs. For example, Lotrel as an FDC had an average monthly drug cost of $115.97 (95% CI = $96.59-$135.36), whereas its counterpart FC had an average monthly drug cost of $21.00 (95% CI = $18.23-$23. 79). Conclusions The cost advantage of FDCs over FCs was reversed when FCs were generically available. The finding of this study informs patients, health-care providers, and drug plans of the importance of making dynamic decisions on preferred drug therapy options depending on the availability of generic drugs.

UR - http://www.scopus.com/inward/record.url?scp=84878837718&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84878837718&partnerID=8YFLogxK

U2 - 10.1093/ajh/hpt035

DO - 10.1093/ajh/hpt035

M3 - Article

VL - 26

SP - 879

EP - 887

JO - American Journal of Hypertension

JF - American Journal of Hypertension

SN - 0895-7061

IS - 7

ER -