Open AccessSingle‐Pill vs Free‐Equivalent Combination Therapies for Hypertension: A Meta‐Analysis of Health Care Costs and Adherence
Author(s) -
Sherrill Beth,
Halpern Michael,
Khan Shahnaz,
Zhang Jie,
Panjabi Sumeet
Publication year - 2011
Publication title -
the journal of clinical hypertension
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.909
H-Index - 67
eISSN - 1751-7176
pISSN - 1524-6175
DOI - 10.1111/j.1751-7176.2011.00550.x
Subject(s) - medicine , pill , confidence interval , meta analysis , pharmacology
J Clin Hypertens (Greenwich) . 2011;13:898–909. ©2011 Wiley Periodicals, Inc. This meta‐analysis compares health care resource use costs, adherence, and persistence between groups of patients taking antihypertensives as single‐pill combinations (SPCs) vs free‐equivalent components (FEC) based on a structured review of published studies. The search yielded 12 retrospective database studies included in analyses. The mean difference in combined total annual all‐cause and hypertension‐related health care costs was $1357 (95% confidence interval [CI], $778–$1935) lower in favor of SPC than FEC groups. Adherence, measured as the mean difference in medication possession ratio, was estimated to be 8% higher for patients naive to prior antihypertensives and 14% higher for nonnaive SPC patients compared with corresponding FEC patients. Persistence in the SPC groups was twice as likely as the FEC groups (pooled risk ratio, 2.1; 95% CI, 1.1–4.1). Improved adherence and persistence may have contributed to the lower costs in the SPC groups via improved clinical outcomes.