The Australian Asthma Handbook does not recommend use of fixed dose combination (FDC) controller medicines for asthma in children aged ≤5 years. FDCs are only recommended in children and adolescents (aged 6–18 years) not responding to initial inhaled corticosteroid (ICS) therapy. Using Pharmaceutical Benefits Scheme dispensing claims from 2013–2018, we examined the annual incident FDC dispensing and the incident FDC dispensing without prior ICS up to 365 days. We also determined cost of FDCs to government and patients. During 2013–2018, there were 35,635 FDC initiations and 31,368 (88%) did not have a preceding ICS dispensing. The annual incidence of FDC dispensing declined from 14.7 to 7.2/1000 children. Incidence of FDC dispensing/1000 children without a preceding ICS declined from 2.1 to 0.5 in children aged 1–2 years, 7.2 to 1.7 in 3–5 years, 14.8 to 5.1 in 6–11 years, and 18.6 to 11.9 in ≥12years. The cost of FDCs was 7.8 million Australian dollars (AUD); of which 4.4 million AUD was to government and 3.3 million AUD was to patient. Despite inappropriate dispensing of FDCs in children aged ≤5 years, incidence of FDC dispensing and more importantly incidence without a preceding ICS is declining in Australia.

中文翻译：

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澳大利亚儿童和青少年哮喘固定剂量联合控制疗法的配药实践。

《澳大利亚哮喘手册》不建议对5岁以下儿童使用固定剂量联合（FDC）控制药物治疗哮喘。仅在对初始吸入皮质类固醇（ICS）治疗无反应的儿童和青少年（6至18岁）中建议使用FDC。使用2013-2018年的《药品福利计划》配药索赔，我们检查了年度事件FDC配给和事件FDC配给（未事先ICS），最长不超过365天。我们还确定了FDC对政府和患者的费用。在2013-2018年期间，有35,635次FDC启动，并且31,368次（88％）未进行过ICS分配。FDC配药的年发生率从14.7名儿童下降到7.2 / 1000名儿童。在没有ICS的情况下，每1000名FDC点胶儿童的发生率在1-2岁儿童中从2.1降至0.5，在3-5岁儿童中从7.2降至1.7，6-11年中为14.8至5.1，≥12年中为18.6至11.9。FDC的成本为780万澳元；其中440万澳元用于政府，330万澳元用于患者。尽管在5岁以下的儿童中FDC分配不当，但在澳大利亚，未分配ICS的FDC分配的发生率以及更重要的是发病率正在下降。