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A Cost-Effective Treatment Approach Using Rosuvastatin+Clopidogrel Fixed Dose Combination (FDC) to Enhance Adherence:
Kishor Pargaonkar1, Sanjeev Chaudhary2, Arijit Roy Choudhury3
1Cardiology, Pargaonkar Hospital, Aurangabad, IND.
Insights
Fixed-dose combination of rosuvastatin and clopidogrel shows high adherence and tolerability in cardiovascular disease management. Cost-effectiveness and simplified dosing are key factors driving patient compliance.
Area of Science:
- Cardiology
- Pharmacology
- Public Health
Background:
- Medication adherence significantly impacts cardiovascular disease (CVD) management.
- Cost-effective treatment strategies are crucial for long-term disease control.
- Fixed-dose combinations (FDCs) offer potential benefits in simplifying treatment regimens.
Purpose of the Study:
- To evaluate medication adherence to a cost-effective fixed-dose combination (FDC) of rosuvastatin and clopidogrel.
- To assess the efficacy and tolerability of this FDC in patients with atherosclerotic cardiovascular disease (ASCVD), post-acute coronary syndrome (ACS), or high cardiovascular risk.
- To identify factors influencing adherence to this combination therapy.
Main Methods:
- Retrospective, non-randomized, non-comparative, multicenter study across 100 Indian healthcare centers.
- Inclusion of patients aged ≥18 years prescribed rosuvastatin and clopidogrel for ASCVD, post-ACS, or high cardiovascular risk.
- Data collection on patient demographics, comorbidities, prescribed doses, adherence rates, reasons for adherence, and physician global evaluations.
Main Results:
- High adherence rate of 95.49% (931/975 patients) to the rosuvastatin-clopidogrel FDC.
- Primary drivers for adherence were decreased cost (68.92%) and simplified dosing (60.41%).
- Physicians rated the efficacy and tolerability of the combination as excellent in over 56% of cases. Higher rosuvastatin dose (20mg) showed significantly better physician ratings.
Conclusions:
- The rosuvastatin-clopidogrel FDC is well-tolerated and demonstrates high adherence in managing patients with ASCVD, post-ACS, and high cardiovascular risk.
- Cost-effectiveness and simplified dosing are critical factors promoting adherence to this cardiovascular medication.
- The FDC represents a valuable and effective therapeutic option for long-term cardiovascular disease management.
Abstract:
Background Medication adherence is mostly influenced by cost, and disease management can be achieved through cost-effective combinations. The present study aimed to evaluate adherence to the cost-effective fixed dose combination (FDC) of rosuvastatin and clopidogrel in the management of cardiovascular diseases (CVD). Methods This retrospective, non-randomized, non-comparative, multicenter study was conducted across 100 healthcare centers in India. Patients aged ≥18 years, of either sex, who were prescribed a combination of rosuvastatin and clopidogrel, and had a clinical diagnosis of atherosclerotic cardiovascular disease (ASCVD) or were post-acute coronary syndrome (ACS) or were at high risk for cardiovascular events, as determined by standard care practices in medicine and cardiology, were included in the study. Results A total of 975 patients were included in the study. Hypertension was the most common comorbidity observed in 749 (76.82%) patients, followed by diabetes in 706 (72.41%) patients. All patients received a clopidogrel dose of 75 mg. However, 492 (50.46%) patients were prescribed rosuvastatin 20 mg, while 483 (49.54%) patients received the 10 mg dose. Adherence to all prescribed doses was reported in 931 patients (95.49%). The most commonly reported reasons for treatment adherence with clopidogrel and rosuvastatin were decreased cost, reported by 672 patients (68.92%), and simplified dosing, reported by 589 patients (60.41%). Furthermore, 548 (56.21%) physicians rated the efficacy of a combination of clopidogrel and rosuvastatin as excellent, while 549 (56.31%) physicians rated its tolerability as excellent. Better adherence and treatment of dyslipidemia were significantly more common reasons for prescribing treatments among patients with an income of >10 lakh compared to those with an income of <5 lakh and five to 10 lakh (P=0.023 and P=0.047, respectively). The physician's global evaluations of both efficacy and tolerability were rated as "Excellent" significantly more commonly in patients receiving the 20 mg dose of rosuvastatin compared to those receiving the 10 mg dose (P=0.004 and P=0.028, respectively). Conclusion The combination of clopidogrel and rosuvastatin was well-tolerated, with high adherence in patients with ASCVD, post-ACS, and those at high cardiovascular risk.
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