Fixed Doses Combinations Acting on Cardiovascular System - Utilization and Generic Competition

Abstract

2 -inhibitors and diuretics, angiotensin receptor blockers (AT receptor blockers, ARBs, sartans) and diuretics. Many new generic molecules as FDCs enter the PDL, thus leading to decrease in the reference price, because of generic competition. The decrease is significant in the new therapeutic groups. The changes in utilization calculated as defined daily dose (DDD)/1000 inhabitants/day show higher utilization in 2013 for the groups of ACE inhibitors and diuretics and AT receptor blockers and diuretics (Enalapril/ Hydrochlorthiazide (HCTZ), Perindopril/ Indapamide, Valsartan/HCTZ, Losartan/ HCTZ). Conclusion:The study confirms that in Bulgaria the generic and therapeutic competition has increased during 2009-2013. It leads to significant price decrease and changes in the trends in utilization of the FDC in cardiology.