A real-world analysis of outcomes and healthcare costs of patients on perindopril/indapamide/amlodipine single-pill vs. multiple-pill combination in Italy.
Adult
Humans
Perindopril
/ therapeutic use
Indapamide
/ therapeutic use
Antihypertensive Agents
/ therapeutic use
Retrospective Studies
State Medicine
Medication Adherence
Amlodipine
/ therapeutic use
Hypertension
/ drug therapy
Drug Combinations
Health Care Costs
Leukemia, Myeloid, Acute
/ drug therapy
Journal
Journal of hypertension
ISSN: 1473-5598
Titre abrégé: J Hypertens
Pays: Netherlands
ID NLM: 8306882
Informations de publication
Date de publication:
01 Jan 2024
01 Jan 2024
Historique:
medline:
4
12
2023
pubmed:
20
9
2023
entrez:
20
9
2023
Statut:
ppublish
Résumé
This analysis compared adherence, cardiovascular (CV) events and all-cause mortality incidence, and healthcare costs among hypertensive patients treated with perindopril (PER)/indapamide (IND)/amlodipine (AML) in single-pill combination (SPC) vs. multiple-pill combination, in a real-world setting in Italy. In this observational retrospective analysis of Italian administrative databases, adult patients treated with PER/IND/AML between 2010 and 2020 were divided into two cohorts: single-pill vs. multiple-pill. Patient data were available for at least one year before and after index date. Propensity score matching (PSM) was applied to reduce selection bias. Adherence was defined as proportion of days covered: non-adherence, <40%; partial adherence, 40-79%, and adherence ≥80%. Mortality incidence and CV events as single, or composite, endpoints were evaluated after first year of follow-up. Healthcare cost analyses were performed from the perspective of the Italian National Health Service. Following PSM, the single-pill cohort included 12 150 patients, and the multiple-pill cohort, 6105. The SPC cohort had a significantly higher percentage of adherent patients vs. the multiple-pill cohort (59.9% vs. 26.9%, P < 0.001). Following the first year of follow-up, incidence of all-cause mortality, and combined endpoint of all-cause mortality and CV events were lower in the SPC cohort compared with multiple-pill cohort. Average annual direct healthcare costs were lower in the single-pill cohort (€2970) vs. multiple-pill cohort (€3642); cost of all drugs and all-cause hospitalizations were major contributors. The SPC of PER/IND/AML, compared with multiple-pill combination, is associated with higher adherence to medication, lower incidence of CV events and mortality, and reduced healthcare costs.
Identifiants
pubmed: 37728093
doi: 10.1097/HJH.0000000000003570
pii: 00004872-990000000-00325
pmc: PMC10712996
doi:
Substances chimiques
Perindopril
Y5GMK36KGY
Indapamide
F089I0511L
Antihypertensive Agents
0
Amlodipine
1J444QC288
Drug Combinations
0
Types de publication
Observational Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
136-142Informations de copyright
Copyright © 2023 The Author(s). Published by Wolters Kluwer Health, Inc.
Références
Lancet. 2021 Sep 11;398(10304):957-980
pubmed: 34450083
Clin Drug Investig. 2019 Apr;39(4):385-393
pubmed: 30790132
Ann Transl Med. 2019 Jan;7(1):16
pubmed: 30788363
Adv Ther. 2017 Jul;34(7):1753-1763
pubmed: 28646394
Eur Heart J. 2022 Sep 14;43(35):3312-3322
pubmed: 35134885
Hypertension. 2015 Mar;65(3):490-8
pubmed: 25624339
High Blood Press Cardiovasc Prev. 2021 Sep;28(5):457-466
pubmed: 34185255
Clin Transl Sci. 2021 May;14(3):1185-1192
pubmed: 33503302
Cardiol Ther. 2017 Jun;6(1):91-104
pubmed: 28181192
J Hum Hypertens. 2017 Aug;31(8):501-510
pubmed: 28230062
Circ Res. 2019 Mar 29;124(7):1113-1123
pubmed: 30920930
J Clin Med. 2021 Dec 17;10(24):
pubmed: 34945217
Lancet. 2021 May 1;397(10285):1625-1636
pubmed: 33933205
J Am Coll Cardiol. 2016 Aug 23;68(8):789-801
pubmed: 27539170
Lancet. 2020 Oct 17;396(10258):1223-1249
pubmed: 33069327
Medicine (Baltimore). 2016 Jul;95(30):e4071
pubmed: 27472680
Lancet. 2015 Nov 21;386(10008):2059-2068
pubmed: 26414968
Int J Cardiol Cardiovasc Risk Prev. 2021 Aug 08;10:200102
pubmed: 35112114
Patient Prefer Adherence. 2019 Nov 11;13:1961-1969
pubmed: 31814712
Curr Med Res Opin. 2018 Sep;34(9):1571-1577
pubmed: 29376432
Kardiologiia. 2020 Jun 03;60(5):1149
pubmed: 32515706
Adv Ther. 2021 Jul;38(7):4013-4025
pubmed: 34115328
N Engl J Med. 2021 May 20;384(20):1921-1930
pubmed: 34010531
Hypertension. 2017 Jun;69(6):1113-1120
pubmed: 28461599
Int J Cardiol. 2013 Sep 30;168(2):928-33
pubmed: 23174167
Biomed Pharmacother. 2019 Dec;120:109539
pubmed: 31627089
Eur Heart J. 2018 Sep 1;39(33):3021-3104
pubmed: 30165516
BMJ Open. 2019 Jun 22;9(6):e029862
pubmed: 31230034
Hypertens Res. 2020 Jul;43(7):705-714
pubmed: 32313192
Am J Cardiovasc Drugs. 2022 May;22(3):355
pubmed: 35352322
J Am Heart Assoc. 2017 Jun 24;6(6):
pubmed: 28647688
High Blood Press Cardiovasc Prev. 2020 Apr;27(2):157-164
pubmed: 32219670
Curr Med Res Opin. 2017 Oct;33(10):1783-1787
pubmed: 28805468