Clinical and economic aspects of fibrates

Today statins are considered as first-line drugs for treating dyslipidemia. Fibrates also have a place in the treatment of dyslipidemia. Taking the above into account it is relevant to highlight the evidence of the effectiveness of these drugs in reducing unfavorable outcomes of cardiovascular diseases (CVD) and feasibility of using them in the complex therapy of dyslipidemia, as well as the study of the pharmacoeconomic characteristics of fibrates presented at the Ukrainian pharmaceutical market. Aim. To analyze the clinical efficacy of fibrates in reducing the consequences of CVD, as well as to study the range, price characteristics, availability and consumption of fibrates at the Ukrainian pharmaceutical market from 2017 to 2019.Materials and methods. The analysis of the evidence of the clinical efficacy of fibrates in patients with CVD and dyslipidemia was performed in accordance to systematic reviews from the international Pubmed database. The retrospective analysis of the assortment, prices, affordability and consumption of fibrates in Ukraine was conducted according to the data from the “PharmXplorer” analytical system of the “Morion” information retrieval company and the Compendium system. The economic affordability was assessed by the value of adequacy of paying capacity (Ca.s.), the consumption volumes – by DDDs (the number of average daily doses) and the number of packages sold during 2017-2019.Results. The evidence of the clinical efficacy of fibrates in reducing cardiovascular events in patients with CVD and DM type 2 with dyslipidemia were summarized in systematic reviews. Within 2017-2019, only 3 trade names (TNs) of foreign fenofibrate, which prices did not fluctuate significantly, were registered at the Ukrainian pharmaceutical market. Fenofibrate drug – Lipofen NS (Nobel, Turkey), caps., 250 mg, blister No. 30, was highly available for the Ukrainian consumer (Ca.s. less than 5.0 %), and Traikor® (Abbot Products GmbH, Germany), film coated tablets, 145 mg, blister No. 20 and No. 30 (Ca.s. more than 5.0 %), were moderately available. The dynamics of the sales growth (2.4 times) of fenofibrate packages in 2019 compared to 2017 was determined due to the growth in sales of Traikor® (film coated tablets, 145 mg, blister No. 20). The dynamics of the increase in consumption of fibrates by the value of DDDs was found. It generally corresponded to the dynamics of sales in the number of packages, but the consumption volumes were insignificant.Conclusions. The use of fibrates in patients with CVD and dyslipidemia for the primary or secondary prevention of risks of adverse cardiovascular events leads to their decrease; moreover, in patients with DM type 2 it helps to reduce the risk of nonfatal myocardial infarction (MI) development. The consumption of fibrates at the Ukrainian pharmaceutical market is insignificant, and is determined by their clinical efficacy and the place in the antihyperlipidemic therapy of CVD where statins prevail today.