CONCEPTUAL COST-EFFECTIVENESS FRAMEWORK FOR GMRX2 (TELMISARTAN/AMLODIPINE/INDAPAMIDE) AS EARLY COMBINATION THERAPY FOR US ADULTS WITH HYPERTENSION WITHOUT MAJOR ATHEROSCLEROTIC CARDIOVASCULAR DISEASE, USED EITHER AT INITIATION OR AS A STEP-UP FROM...
Author(s)
Michael Groff, BSc, MSc1, Vijay Anand, PharmD2, Amy K. Carroll, Ph.D3, Angie Raad, PhD.1;
1Cytel, Evidence, Value, and Access (EVA), Toronto, ON, Canada, 2Azurity Pharmaceuticals, Woburn, MA, USA, 3George Medicines, San Diego, CA, USA
1Cytel, Evidence, Value, and Access (EVA), Toronto, ON, Canada, 2Azurity Pharmaceuticals, Woburn, MA, USA, 3George Medicines, San Diego, CA, USA
OBJECTIVES: Hypertension remains a leading driver of preventable cardiovascular disease (CVD) and healthcare resource utilization (HCRU) in the United States (US), with suboptimal blood pressure (BP) control persisting despite effective therapies. Delayed intensification, low-efficacy monotherapy, complex multi-pill regimens, and poor adherence contribute to downstream cardiovascular events and long-term costs. This study describes the conceptual framework for a US cost-effectiveness model evaluating GMRx2 (telmisartan/amlodipine/indapamide), a triple, single-pill combination (SPC), versus current early-step hypertension treatment strategies.
METHODS: GMRx2 was tested in three phase 3 clinical trials evaluating placebo-controlled efficacy, comparative effectiveness versus dual therapy, and comparison to standard of care. Based on these studies’ results, a cohort-level Markov model is being developed from a US payer perspective to estimate health outcomes and lifetime costs in adults with essential hypertension without prior major atherosclerotic CVD. Health states include no CVD, first cardiovascular events (myocardial infarction, stroke, heart failure, angina, transient ischemic attack), post-event states, and death, with achieved systolic BP (SBP) linking treatment effects to downstream cardiovascular risk using validated risk equations. Chronic kidney disease (CKD), a costly comorbidity of hypertension, is modelled in parallel to capture its high lifetime incidence and associated cost and quality-of-life burden, using evidence linking SBP to CKD risk. Network meta-analysis informs comparator SBP reductions for monotherapy and dual-therapy, enabling class- and dose-specific efficacy estimates relevant to US practice. Real-world treatment adherence is incorporated as a modifier of SBP reduction.
RESULTS: Within this conceptual framework, reductions in achieved SBP translate into long-term reductions in first cardiovascular events. Lifetime economic outcomes are driven by avoidance of high-cost, post-event, cardiovascular health states and downstream HCRU.
CONCLUSIONS: By anchoring treatment effects to achieved SBP, the framework captures the impact of early BP control with triple, SPC-based therapy on preventing initial cardiovascular events and subsequent disease burden, supporting a prevention-driven perspective relevant to US payer decision-making.
METHODS: GMRx2 was tested in three phase 3 clinical trials evaluating placebo-controlled efficacy, comparative effectiveness versus dual therapy, and comparison to standard of care. Based on these studies’ results, a cohort-level Markov model is being developed from a US payer perspective to estimate health outcomes and lifetime costs in adults with essential hypertension without prior major atherosclerotic CVD. Health states include no CVD, first cardiovascular events (myocardial infarction, stroke, heart failure, angina, transient ischemic attack), post-event states, and death, with achieved systolic BP (SBP) linking treatment effects to downstream cardiovascular risk using validated risk equations. Chronic kidney disease (CKD), a costly comorbidity of hypertension, is modelled in parallel to capture its high lifetime incidence and associated cost and quality-of-life burden, using evidence linking SBP to CKD risk. Network meta-analysis informs comparator SBP reductions for monotherapy and dual-therapy, enabling class- and dose-specific efficacy estimates relevant to US practice. Real-world treatment adherence is incorporated as a modifier of SBP reduction.
RESULTS: Within this conceptual framework, reductions in achieved SBP translate into long-term reductions in first cardiovascular events. Lifetime economic outcomes are driven by avoidance of high-cost, post-event, cardiovascular health states and downstream HCRU.
CONCLUSIONS: By anchoring treatment effects to achieved SBP, the framework captures the impact of early BP control with triple, SPC-based therapy on preventing initial cardiovascular events and subsequent disease burden, supporting a prevention-driven perspective relevant to US payer decision-making.
Conference/Value in Health Info
2026-05, ISPOR 2026, Philadelphia, PA, USA
Value in Health, Volume 29, Issue S6
Code
EE218
Topic
Economic Evaluation
Disease
SDC: Cardiovascular Disorders (including MI, Stroke, Circulatory), SDC: Urinary/Kidney Disorders