Pricing and Reimbursement of Fixed-Dose Combination Drugs in the United States

Introduction

Fixed-dose combinations (FDCs) of prescription drugs can prove clinically useful where polypharmacy is required-for example, in the management of HIV, asthma, and cardiometabolic disorders such as diabetes, dyslipidemia, and hypertension. These products also offer pharmaceutical companies a relatively easy and inexpensive way to bring new drugs to market. However, new surveys of 40 managed care organization (MCO) medical/pharmacy directors and more than 400 physicians, together with a detailed analysis of health plan formularies, show that payers and physicians have mixed opinions about these products.

Get the Answers You Need to Shape Your Strategy

• By reducing the number of medication doses that a patient must take, FDCs offer greater patient convenience and may improve adherence. How important do physicians and payers consider these advantages? What other advantages are FDCs perceived to offer? What disadvantages do physicians and payers see in FDCs?
• Companies planning to launch an FDC should not expect to command substantial price premiums over the price of the respective single agents. How do pricing trends vary by therapeutic area? How does the availability of generic versions of single agents infl uence the pricing of FDCs?
• Pharmaceutical companies face substantial challenges in securing favorable coverage for FDCs. How does formulary status vary by drug class? What factors infl uence formulary positioning? What drug utilization management tools do MCOs apply to FDCs in each drug class?

• General drug benefi t and coverage trends: key factors in reimbursement decision making; formulary design trends; copayment trends; cost-containment measures.
• HIV therapies: current therapies; pricing; formulary status; physician and MCO views.
• Asthma drugs: current therapies; pricing; formulary status; physician views.
• Cardiometabolic drugs (antidiabetics, antidyslipidemics, antihypertensives): current therapies; pricing; formulary status; physician and MCO views.