Fixed dose combination products have little impact on medicines adherence

While persistence rates favoured patients taking a fixed dose combination of a statin and ezetimibe, it made no difference to adherence, researchers found.

Open pill bottle with different medicines spilling out

Fixed dose combination (FDC) medicines reduce the pill burden of patients and have been shown to improve adherence in patients taking statins.

Australian researchers compared differences in adherence and persistence (the length of time on treatment) in people who added ezetimibe to existing statin therapy. There were 3,651 people who initiated ezetimibe and statin separately, with 5,740 who initiated the combination as a FDC.

There was no significant difference in adherence between the two groups but persistence rates for initial combination medicines favoured those taking the FDC (49.1% for separate tablets versus 62.4%; hazard ratio 1.81, 95% confidence interval 1.76–1.90). However, when persistence to any two lipid-lowering therapies was considered, the proportion of people continuing dual lipid-lowering therapy at 12 months follow-up was similar in both cohorts.

Published in the British Journal of Clinical Pharmacology
(online, 29 September 2016), the results suggest that FDC products have little impact on adherence or persistence compared with combination lipid-lowering therapy in patients who were experienced at taking statins, contradicting other research.


[1] Bartlett LE, Pratt N & Roughead EE. Does tablet formulation alone improve adherence and persistence: a comparison of ezetimibe fixed dose combination versus ezetimibe separate pill combination? Br J Clin Pharmacol 2016. doi: 10.1111/bcp.13088

Last updated
Clinical Pharmacist, CP, December 2016, Vol 8, No 12;8(12):DOI:10.1211/PJ.2016.20202000

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