Drug companies charge taxpayers extra for combined therapies From December, taxpayers will be spending a staggering $50 million-plus a year extra on combination medicines. IT'S the great drug company con - combining a $2.71 blood pressure pill with a $19.32 anti-cholesterol tablet, then charging taxpayers $55.66. From December, taxpayers will be spending a staggering $50 million-plus a year extra on combination medicines - which mix two or more therapies into a single pill. This money could be saved if the patients bought two pills and swallowed them separately. The combination remedies give drug companies a new way to avoid cuts to prices of individual drugs under a government price disclosure policy. One expert is demanding a review of the way combination medicines are funded under the Pharmaceutical Benefits Scheme, to ensure the public is getting value for money. "While there may be benefits to patients from having to take fewer tablets each day, given the overall high cost it would be worth conducting a review to see whether such combinations represent value for money," said Melbourne University health economist Philip Clarke. "It would seem sensible to base the price of combination therapies on the cost of the individual drugs, with an added premium for any proven additional benefits to the patient from taking fewer tablets," Professor Clarke said. Some patients, confused or overburdened by having to take multiple pills, can stop taking medicine, so their illness is not properly controlled. Medical studies have shown combining more than one medicine in a single pill can improve a patient's treatment compliance by 30 per cent. Consumers pay just one, not two PBS charges of $5.90 if they are a pensioner, or $36.10 if they are a general consumer. But combination pills were originally subsidised on the PBS on a cost minimisation basis. Government guidelines say: "The pricing of a combination product would normally be no greater than the sum of its individual components." This was the case when the medicines were first subsidised in 2006. But the price of atorvastatin in the amlodipine/atorvastatin combination pill will fall by as much as 50 per cent on December 1, under a government price disclosure process. Yet the price of the combination pill will remain at today's price of $55.66. The Herald Sun asked the Department of Health and Ageing whether there was evidence the combination pill produced health savings equivalent to their higher cost. A spokesman said it was the job of the independent Pharmaceutical Benefits Advisory Committee to consider the cost-effectiveness of a medicine. "Where a combination item is listed on the PBS, it is because it meets this measure," the spokesman said. More than 20 combination pills are subsidised by the Pharmaceutical Benefits Scheme. They make up over 10 per cent of sales in some categories. More than a million scripts of amlodipine/atorvastatin were sold last year. The two biggest-selling combination pills are the amlodipine/atorvastatin combination, and a pill combining two cholesterol-lowering drugs, ezetimibe and simvastatin. When it is sold on its own, the dispensed price for ezetimibe is $71.18 for 10mg and simvastatin costs $15.63 for 40mg. When they are combined into one pill, the charge is $21.25 higher - $108.06.