Too many kids on fixed dose asthma combos

boy wtih asthma uses reliever puffer

A post market review of medicines to treat asthma has found that 40% of children with the illness are supplied with a fixed dose combination product contrary to current asthma management guidelines.

Under the Australian Government’s National Medicines Policy framework, the Department of Health’s objective for this review was to evaluate the clinical evidence regarding asthma medicine interventions to ensure the most appropriate management of children with asthma in clinical practice.

The need for this review was first identified by the Paediatric Medicines Advisory Group, which found that 40% of the children supplied with a fixed dose combination product (of inhaled long-acting beta-agonists and inhaled corticosteroids), had not first been prescribed a single ingredient product (an inhaled corticosteroid).

PMAG considered that the extent of FDC use in paediatric asthma was a serious quality use of medicines issue and subsequently referred the matter to the Drug Utilisation Sub-Committee of the Pharmaceutical Benefits Advisory Committee.

In 2011, the DUSC review indicated that there was a very high rate of initiation to a FDC without prior use of a single ingredient inhaler.

This is contrary to current asthma management guidelines (Asthma Management Handbook 2006, National Asthma Council Australia). The DUSC noted the issues and advised sponsors that this is a complex area of treatment and further clarification of the issues surrounding asthma management in children was needed.

The PBS listed medicines included in this review were: salmeterol with fluticasone, eformoterol with budesonide, beclomethasone dipropionate, ciclesonide, sodium cromoglycate and nedocromil sodium, montelukast, salmeterol and eformoterol.



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