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. 2020 Aug 5;17(16):5645.
doi: 10.3390/ijerph17165645.

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

Nusrat Homaira  1   2 , Benjamin Daniels  3 , Sallie Pearson  3 , Adam Jaffe  1   2
Affiliations

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

Nusrat Homaira et al. Int J Environ Res Public Health. .

Abstract

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.

Keywords: asthma controller; children; dispensing pattern.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Year and age specific incident dispensing of any fixed dose combination medicines in 10% PBS sample of Australian children aged 1–18 years, 2013–2018.
Figure 2
Figure 2
Year and age specific incident dispensing of any fixed dose combination medicine without a preceding dispensing of inhaled corticosteroid in 10% PBS sample of Australian children aged 1–18 years, 2013–2018.
See this image and copyright information in PMC

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