Duplicate Prescriptions of Inhaled Medications for Obstructive Lung Diseases

Pneumologie ◽  
2020 ◽  
Vol 74 (03) ◽  
pp. 149-158
Author(s):  
P. Kardos ◽  
F. Geiss ◽  
J. Simon ◽  
C. Franken ◽  
U. Butt ◽  
...  
Keyword(s):  
Lung Diseases ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Dry Powder Inhalers ◽  
Mail Order ◽  
Inhaled Corticosteroid ◽  
German Market ◽  
Metered Dose ◽  
Mail Order Pharmacy ◽  
Dose Combination

Abstract Introduction Inhalative treatments with metered dose aerosols and dry powder inhalers are the backbone of the pharmacotherapy for asthma and COPD. In the last decade many new and generic inhalative bronchodilators were launched at the German market, both monotherapies and fixed dose double bronchodilator (LABA/LAMA, beta adrenergic and antimuscarinic) or LABA and inhaled corticosteroid (ICS) and triple (LABA/LAMA/ICS) combinations. According to two surveys in 2015 among respiratory physicians we expected a high proportion of patients receiving duplicate prescriptions, e. g. a fixed dose new LABA/LAMA combination in addition to an existing ICS/LABA fixed dose combination. Methodology We searched the database of a large mail order pharmacy (DocMorris) to identify duplicate prescriptions of inhalative drugs for a patient by the same or by two or more different physicians during a 3 months period. Results Unexpectedly, we found as little as around 1 % duplicate prescriptions for the same patient. Duplicate prescriptions involving combination products were found to be much more common than duplicate prescriptions of different mono-products. Irrespective the low percentage number of all prescriptions we saw in just one large mail order pharmacy several thousands of erroneous prescriptions. Conclusion At least in the setting of this mail order pharmacy duplicate (i. e. contraindicated and potentially dangerous) prescriptions are relatively rare. Prescribers and pharmacists should be aware of the issue of duplicates – especially when prescribing or filling prescriptions with combination products.

scholarly journals Cost-effectiveness of the fixed-dose combination tiotropium/olodaterol versus tiotropium monotherapy or a fixed-dose combination of long-acting β2-agonist/inhaled corticosteroid for COPD in Finland, Sweden and the Netherlands: a model-based study

BMJ Open ◽  
2021 ◽  
Vol 11 (8) ◽  
pp. e049675
Author(s):  
Martine Hoogendoorn ◽  
Isaac Corro Ramos ◽  
Stéphane Soulard ◽  
Jennifer Cook ◽  
Erkki Soini ◽  
...  
Keyword(s):  
Cost Effectiveness ◽  
The Netherlands ◽  
Cost Effective ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Inhaled Corticosteroid ◽  
Dose Combination ◽  
Long Acting ◽  
Β2 Agonist ◽  
Country Specific

ObjectivesChronic obstructive pulmonary disease (COPD) guidelines advocate treatment with combinations of long-acting bronchodilators for patients with COPD who have persistent symptoms or continue to have exacerbations while using a single bronchodilator. This study assessed the cost-utility of the fixed dose combination of the bronchodilators tiotropium and olodaterol versus two comparators, tiotropium monotherapy and long-acting β2 agonist/inhaled corticosteroid (LABA/ICS) combinations, in three European countries: Finland, Sweden and the Netherlands.MethodsA previously published COPD patient-level discrete event simulation model was updated with most recent evidence to estimate lifetime quality-adjusted life years (QALYs) and costs for COPD patients receiving either tiotropium/olodaterol, tiotropium monotherapy or LABA/ICS. Treatment efficacy covered impact on trough forced expiratory volume in 1 s (FEV1), total and severe exacerbations and pneumonias. The unit costs of medication, maintenance treatment, exacerbations and pneumonias were obtained for each country. The country-specific analyses adhered to the Finnish, Swedish and Dutch pharmacoeconomic guidelines, respectively.ResultsTreatment with tiotropium/olodaterol gained QALYs ranging from 0.09 (Finland and Sweden) to 0.11 (the Netherlands) versus tiotropium and 0.23 (Finland and Sweden) to 0.28 (the Netherlands) versus LABA/ICS. The Finnish payer’s incremental cost-effectiveness ratio (ICER) of tiotropium/olodaterol was €11 000/QALY versus tiotropium and dominant versus LABA/ICS. The Swedish ICERs were €6200/QALY and dominant, respectively (societal perspective). The Dutch ICERs were €14 400 and €9200, respectively (societal perspective). The probability that tiotropium/olodaterol was cost-effective compared with tiotropium at the country-specific (unofficial) threshold values for the maximum willingness to pay for a QALY was 84% for Finland, 98% for Sweden and 99% for the Netherlands. Compared with LABA/ICS, this probability was 100% for all three countries.ConclusionsBased on the simulations, tiotropium/olodaterol is a cost-effective treatment option versus tiotropium or LABA/ICS in all three countries. In both Finland and Sweden, tiotropium/olodaterol is more effective and cost saving (ie, dominant) in comparison with LABA/ICS.

scholarly journals Dispensing Practices of Fixed Dose Combination Controller Therapy for Asthma in Australian Children and Adolescents

2020 ◽  
Vol 17 (16) ◽  
pp. 5645
Author(s):  
Nusrat Homaira ◽  
Benjamin Daniels ◽  
Sallie Pearson ◽  
Adam Jaffe
Keyword(s):  
Children And Adolescents ◽  
Annual Incidence ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Inhaled Corticosteroid ◽  
Dispensing Practices ◽  
Dose Combination ◽  
Asthma In Children ◽  
The Cost ◽  
Pharmaceutical Benefits Scheme

The Australian Asthma Handbook does not recommend use of fixed dose combination (FDC) controller medicines for asthma in children aged ≤5 years. FDCs are only recommended in children and adolescents (aged 6–18 years) not responding to initial inhaled corticosteroid (ICS) therapy. Using Pharmaceutical Benefits Scheme dispensing claims from 2013–2018, we examined the annual incident FDC dispensing and the incident FDC dispensing without prior ICS up to 365 days. We also determined cost of FDCs to government and patients. During 2013–2018, there were 35,635 FDC initiations and 31,368 (88%) did not have a preceding ICS dispensing. The annual incidence of FDC dispensing declined from 14.7 to 7.2/1000 children. Incidence of FDC dispensing/1000 children without a preceding ICS declined from 2.1 to 0.5 in children aged 1–2 years, 7.2 to 1.7 in 3–5 years, 14.8 to 5.1 in 6–11 years, and 18.6 to 11.9 in ≥12years. The cost of FDCs was 7.8 million Australian dollars (AUD); of which 4.4 million AUD was to government and 3.3 million AUD was to patient. Despite inappropriate dispensing of FDCs in children aged ≤5 years, incidence of FDC dispensing and more importantly incidence without a preceding ICS is declining in Australia.

scholarly journals 12-Hour fixed-dose combination of andrenergic agonist and cholinergic antagonist in a new administration device: analytical review

2018 ◽  
pp. 116-122
Author(s):  
A. A. Vizel ◽  
I. Yu. Vizel
Keyword(s):  
Dry Powder Inhaler ◽  
Feedback Mechanism ◽  
Fixed Dose Combination ◽  
Fixed Dose ◽  
Chronic Obstructive ◽  
Informative Feedback ◽  
Obstructive Pulmonary Disease ◽  
Metered Dose ◽  
Analytical Review ◽  
Dose Combination

The article presents an analytical review of the use of aclidinium, formoterol, and combination of aclidinium and formoterol to treat chronic obstructive pulmonary disease (COPD) using a metered-dose dry powder inhaler Genuair® to administer a fixeddose combination. It is noted that twelve hours’ double bronchodilating effect has some advantages including the rapid elimination of drugs having minimal systemic effects, significant effect on dyspnoea and exhalation rates, profitability of using this drug. It is proven that Genuair® is a new, patient-friendly, easy to administer at any age powder inhaler with an informative feedback mechanism. All this makes it possible to consider a new fixed-dose combination of bronchodilators in the innovative device to be a promising basic therapy for COPD.

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