Research on the consumption of two-component fixed combinations of medicines for the treatment of arterial hypertension in Ukraine in the period from 2020-2023 and the use of the results in the context of optimization of pharmaceutical assistance and the prospects of their inclusion in state reimbursement programs

Abstract

The aim to conduct a retrospective study of the consumption of 4 groups of two-component combined drugs for the treatment of arterial hypertension and to determine the structure of their consumption by the number of tablets, taking into account active substances and their doses, to further formulate proposals to improve the provision of medicines to consumers, in particular through the state reimbursement program “Affordable Medicines”. Materials and methods: The objects of the study were retail sales data for the period 2020–2024 on the pharmaceutical market of Ukraine for four groups of combined antihypertensive drugs. The data was provided by the Ukrainian pharmaceutical market research system «Pharmstandard» of the Morion company. The study used statistical and mathematical methods, as well as content analysis, comparative, logical, and systemic analysis, and data generalization. Results: showed that combined drugs of ACE inhibitors and diuretics are the most consumed among all two-component combined drugs for the treatment of hypertension in Ukraine in 2020–2023. By median share of consumption, the following fixed-dose combinations of captopril/HCTZ (50 mg/25 mg) median 29.04%; enalapril/HCTZ (10 mg/25 mg) median 11.74%; lisinopril/HCTZ (10 mg/12.5 mg) median 11.64% and perin- dopril tertbutylamine with indapamide (8 mg/2.5 mg) – 11.42% among ACE inhibitors and diuretics combinations; valsartan/HCTZ (160 mg/12.5 mg (median 40.02%); and 80 mg/12.5 mg (median 29.07%); losartan/HCTZ (50 mg/12.5 mg) median 11.30% among ARB and diuretic combinations; lisinopril/amlodipine (5 mg/5 mg) median 15.25%; and (10 mg/5 mg) median 11.98% perindopril arginine and amlodipine (5 mg/5 mg) median 13.77%; and perindopril tertbutylamine and amlodipine (4 mg/5 mg) median 11.08%; of all combinations of ACE inhibitors and CCBs; and valsartan/amlodipine, in all three available doses (160 mg/5 mg, 80 mg/5 mg and 160 mg/10 mg) median 43.71%; 31.36% and 20.32% respectively, among the combinations of ARBs and CCBs had the highest median consumption share in each respective group of combination drugs and were used by patients for the treatment of hypertension in Ukraine in 2020–2024. Conclusion: Retail sales results showed that combined drugs of ACE inhibitors and diuretics, as well as combined drugs of ARBs and diuretics, are the most consumed among all two-component combined drugs for the treatment of hypertension in Ukraine in 2020–2023. Further analysis of the structure of consumption of fixed-dose combinations, considering active substances and their doses, made it possible to determine within each study group those fixed doses that have the highest median consumption share values over four years. It is regarding them that we propose conducting further clinical and economic studies on their use in the context of discussing the issue of expanding the list of combined drugs for the treatment of hypertension that are subject toreimbursement in Ukraine.