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Facilitators and Barriers of Incremental Innovation by Fixed Dose Combinations in Cardiovascular Diseases

András Inotai1,2, Zoltán Kaló1,2, Zsuzsanna Petykó1,2

  • 1Center for Health Technology Assessment, Semmelweis University, 1091 Budapest, Hungary.

Journal of Cardiovascular Development and Disease
|July 26, 2024
PubMed

Insights

Fixed-dose combinations (FDCs) improve cardiovascular disease treatment adherence but face barriers. Overcoming these requires better evidence, policy acceptance, and fair pricing to incentivize innovation.

Area of Science:

  • Pharmacology and Cardiovascular Medicine
  • Health Services Research
  • Health Economics

Background:

  • Cardiovascular diseases (CVDs) remain poorly controlled despite available treatments.
  • Fixed-dose combinations (FDCs) offer incremental innovation, improving adherence and clinical outcomes compared to single-drug regimens.

Purpose of the Study:

  • To identify barriers hindering the wider adoption of FDCs for CVD treatment.
  • To explore system-level facilitators for FDC implementation from a multi-stakeholder viewpoint.

Main Methods:

  • Multi-stakeholder perspective analysis to identify barriers and facilitators.
  • Review of evidence generation, clinical guideline development, healthcare payer policies, and real-world evidence availability.

Main Results:

  • Identified barriers include evidence generation challenges, limited acceptance of adherence as an endpoint, restricted price premiums for payers, insufficient real-world evidence, and adherence measurement issues.
  • Facilitators include standardized healthcare databases, patient-centric healthcare movements, and extended value assessment frameworks.

Conclusions:

  • Addressing barriers in evidence, policy, and reimbursement is crucial for FDC utilization in CVDs.
  • Standardizing data, enhancing patient centricity, and demonstrating value are key opportunities.
  • Convincing payers to offer fair premium pricing is essential to incentivize incremental innovation in FDCs for cardiovascular disease management.
Keywords:
adherencecardiovascular diseasesfixed dose combinationincremental innovationmedicinepolypillpricingreal world datareimbursement

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