Related Experiment Video

Updated: Dec 14, 2025

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform
07:13

Digital Home-Monitoring of Patients after Kidney Transplantation: The MACCS Platform

Published on: April 12, 2021

4.8K

Cost-effectiveness analysis of antihypertensive triple combination therapy among patients enrolled in a Medicare

Xin Wang1, Hua Chen1, Essien E1

  • 1Department of Pharmaceutical Health Outcomes and Policy, College of Pharmacy, University of Houston, Houston, TX, USA.

Expert Review of Pharmacoeconomics & Outcomes Research
|July 25, 2020
PubMed

Insights

Single pill triple combination therapy for hypertension is cost-effective compared to free-drug regimens, particularly under strict adherence criteria. This approach offers better value in preventing cardiovascular events.

Area of Science:

  • Cardiovascular Medicine
  • Health Economics
  • Pharmacoeconomics

Background:

  • Hypertension management often involves multiple medications, impacting patient adherence and healthcare costs.
  • Triple combination therapy aims to improve blood pressure control and reduce cardiovascular event risk.
  • Fixed-dose single-pill therapies offer potential advantages in adherence and cost-effectiveness over free-drug combinations.

Purpose of the Study:

  • To evaluate the cost-effectiveness of single-pill fixed-dose triple combination therapy versus free-drug triple combination therapy for cardiovascular event prevention in hypertensive patients.
  • To compare health outcomes, measured in Quality-Adjusted Life Years (QALYs), and healthcare costs between the two therapeutic approaches.
  • To determine the Incremental Cost-Effectiveness Ratio (ICER) for single-pill therapy relative to free-drug therapy.

Main Methods:

  • A Markov model with a five-year cycle was employed for the cost-effectiveness analysis.
  • Two decision models were developed, incorporating both strict and relaxed adherence definitions.
  • Quality-Adjusted Life Years (QALYs) and health-care costs were estimated for each treatment strategy.

Main Results:

  • Under strict adherence criteria, single-pill therapy resulted in a QALYs loss of 6.38 and costs of $486,026.20 per patient, versus 8.64 QALYs loss and $406,405.26 for free combination therapy.
  • The ICER for single-pill therapy compared to free combination therapy was $33,826.46 per QALY gained under strict adherence.
  • Under relaxed adherence criteria, the ICER increased to $84,932.26 per QALY gained, with QALYs loss of 8.09 and costs of $493,404.26 for single-pill therapy versus 8.76 QALYs loss and $436,415.14 for free combination therapy.

Conclusions:

  • Single-pill triple combination therapy demonstrated cost-effectiveness compared to free combination therapy when a willingness-to-pay threshold of $50,000 per QALY was applied, specifically under strict adherence criteria.
  • The findings suggest that improved adherence facilitated by single-pill formulations can enhance the economic value of triple therapy in hypertension management.
  • Optimizing adherence through fixed-dose combinations is crucial for achieving favorable cost-effectiveness outcomes in cardiovascular disease prevention.
Abstract

Keywords:
Combination antihypertensiveadherencecost-effectivenessfree drugsingle pill

More Related Videos

Diagonal Method to Measure Synergy Among Any Number of Drugs12:08

Diagonal Method to Measure Synergy Among Any Number of Drugs

Published on: June 21, 2018

19.3K
Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease06:16

Signal Acquisition, Score Interpretation, and Economics of a Non-Invasive Point-of-Care Test for Coronary Artery Disease

Published on: August 9, 2024

711

Related Concept Videos

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System01:26

Heart Failure Drugs: Inhibitors of Renin-Angiotensin System

The activation of the sympathetic nervous system and the renin-angiotensin-aldosterone system (RAAS) contributes to cardiac remodeling, and inhibiting the RAAS is a pharmacological target in heart failure management. As a result, neurohumoral modulation is a crucial treatment principle for managing heart failure. This approach involves using medications like ACE inhibitors (ACEIs), angiotensin receptor blockers (ARBs), β-blockers, mineralocorticoid receptor antagonists (MRAs), and neutral...
771
Heart Failure V: Medical Management01:30

Heart Failure V: Medical Management

Medical Management of Acute Decompensated Heart Failure (ADHF)The primary goals of therapy for patients hospitalized with acute decompensated heart failure (ADHF) include:Relieving symptomsOptimizing volume statusSupporting oxygenation and ventilationMaintaining cardiac output (CO) and end-organ perfusionIdentifying and addressing the cause of ADHFPreventing complicationsProviding patient education on factors precipitating HF exacerbationPlanning for dischargeOngoing monitoring and assessment...
131
Hypertension IV: Drug Therapy and Lifestyle Modifications01:28

Hypertension IV: Drug Therapy and Lifestyle Modifications

Multiple classes of antihypertensive medications are employed in treating hypertension. The most commonly recommended first-line treatments include:Thiazide Diuretics, such as chlorthalidone, increase sodium and water excretion from the body, reducing blood volume and blood pressure.Angiotensin-converting enzyme inhibitors, like lisinopril, block the conversion of angiotensin I to II, a potent vasoconstrictor lowering blood pressure.Angiotensin II Receptor Blockers (ARBs) prevent angiotensin II...
442
Peripheral Artery Disease III: Interprofessional Care01:27

Peripheral Artery Disease III: Interprofessional Care

Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
161
Combined Effects of Drugs: Synergism01:27

Combined Effects of Drugs: Synergism

Synergism is a useful mechanism where combining two or more drugs is more effective than each constituent used alone. Such combinations are also called supra-additive interactions. The drugs collectively enhance the final therapeutic effect by acting on different targets. Another advantage is that the low dose of each constituent drug is sufficient to achieve the desired effect. This helps reduce the duration of therapy and lower the adverse effects of these drugs.
Such synergistic combinations...
6.6K
Antihypertensive Drugs: Direct Renin Inhibitors01:25

Antihypertensive Drugs: Direct Renin Inhibitors

The renin-angiotensin-aldosterone system (RAAS) is an intricate physiological pathway involving numerous enzymes and hormones, including renin, angiotensin-converting enzyme (ACE), angiotensin I and II, and aldosterone. Imbalances within this system increase the production of angiotensin II and aldosterone. Increased angiotensin II levels promote vasoconstriction and blood pressure elevation. Concurrently, higher aldosterone levels stimulate sodium and water reabsorption in the kidneys,...
1.1K