Cost-effectiveness analysis comparing single-pill combination of perindopril/amlodipine/indapamide to the free equivalent combination in patients with hypertension from an Italian national health system perspective.

Publisher: Taylor & Francis Country of Publication: England NLM ID: 101132257 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1744-8379 (Electronic) Linking ISSN: 14737167 NLM ISO Abbreviation: Expert Rev Pharmacoecon Outcomes Res Subsets: MEDLINE

Publication: 2015- : Abingdon, Oxford : Taylor & Francis
Original Publication: London : Future Drugs Ltd, [2001-

Indapamide*/administration & dosage ; Indapamide*/economics ; Perindopril*/administration & dosage ; Perindopril*/economics ; Cost-Benefit Analysis* ; Hypertension*/drug therapy ; Antihypertensive Agents*/administration & dosage ; Antihypertensive Agents*/economics ; Amlodipine*/administration & dosage ; Amlodipine*/economics ; Drug Combinations* ; Markov Chains* ; Quality-Adjusted Life Years*; Humans ; Italy ; Medication Adherence ; Blood Pressure/drug effects ; Adult ; Middle Aged ; National Health Programs/economics ; Cardiovascular Diseases/economics ; Cardiovascular Diseases/prevention & control ; Male ; Cost Savings ; Female ; Aged ; Cost-Effectiveness Analysis

Objective: To evaluate the cost-effectiveness of a single-pill combination (SPC) of perindopril/amlodipine/indapamide versus its free equivalent combination (FEC) in adults with hypertension in Italy.
Methods: A Markov model was developed to perform a cost-utility analysis with a lifetime horizon and an Italian healthcare payer's perspective. In the model, the additional effect of the SPC on blood pressure level compared with the FEC was translated into a decreased risk of cardiovascular events and CKD, which was modeled via Framingham risk algorithms. Difference in persistence rates of SPC and FEC were modeled via discontinuation rates.
Results: A perindopril/amlodipine/indapamide SPC is associated with lower cost and better health outcomes compared to its FEC. Over a lifetime horizon, it is associated with a 0.050 QALY gain and cost savings of €376, resulting from lower cardiovascular event rates. In the alternative scenario, where different approach for modeling impact of adherence was considered, incremental gain of 0.069 QALY and savings of €1,004 were observed. Results were robust to sensitivity and scenario analyses, indicating that use of this SPC is a cost-effective strategy.
Conclusions: The findings indicate that a perindopril/amlodipine/indapamide SPC is a cost-saving treatment option for hypertension in Italy, compared to its FEC.

Keywords: Hypertension; adherence; cost-effectiveness; fixed-dose; persistence; single-pill combination

F089I0511L (Indapamide)
Y5GMK36KGY (Perindopril)
0 (Antihypertensive Agents)
1J444QC288 (Amlodipine)
0 (Drug Combinations)
0 (amlodipine, perindopril drug combination)

Date Created: 20240607 Date Completed: 20240920 Latest Revision: 20240920

20240921

10.1080/14737167.2024.2365988

38848115