Single-Pill vs Free-Equivalent Combination Therapies for Hypertension: A Meta-Analysis of Health Care Costs and Adherence

Beth Sherrill, Michael Halpern, Shahnaz Khan, Jie Zhang, Sumeet Panjabi

Research output: Contribution to journalArticle

99 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Pages (from-to)898-909
Number of pages12
JournalJournal of Clinical Hypertension
Volume13
Issue number12
DOIs
StatePublished - Dec 2011
Externally publishedYes

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Health Care Costs
Meta-Analysis
Hypertension
Antihypertensive Agents
Confidence Intervals
Costs and Cost Analysis
Health Resources
Therapeutics
Retrospective Studies
Odds Ratio
Databases
Delivery of Health Care

ASJC Scopus subject areas

  • Internal Medicine
  • Cardiology and Cardiovascular Medicine
  • Endocrinology, Diabetes and Metabolism

Cite this

Single-Pill vs Free-Equivalent Combination Therapies for Hypertension : A Meta-Analysis of Health Care Costs and Adherence. / Sherrill, Beth; Halpern, Michael; Khan, Shahnaz; Zhang, Jie; Panjabi, Sumeet.

In: Journal of Clinical Hypertension, Vol. 13, No. 12, 12.2011, p. 898-909.

Research output: Contribution to journalArticle

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