OBJECTIVES

The primary objective of the study was to assess the budget impact of a single-pill combination (SPC) of rosuvastatin and ezetimibe for hyperlipidaemia treatment from a Greek third-party payer (EOPYY) perspective. The SPC is indicated as substitution therapy in adult patients adequately controlled with the same agents as free combination (FC). Several studies and clinical guidelines suggest that SPCs are preferred to FCs, as the improved adherence to medication could result in fewer cardiovascular (CV) events.

METHODS :

A budget impact model (BIM) within a five-year horizon was developed. Treatment costs and management of cardiovascular events due to non-adherence were considered. A Markov model was developed to predict the possibility of cardiovascular events in the high-risk reference population and the transition probabilities between five health states (no event, Non-Fatal MI, Stroke, CVD death, all death) were calculated by using the Framingham and SCORE algorithms. The correlation of the relative risk of cardiovascular complications was calculated according the adherence and non-adherence in hypolipidemic treatment (Chowdhury et al. 2013). Patients moved between health states in yearly cycles.

RESULTS

The estimated population receiving the Rosu/Eze FC was 47,988 (2.27% of the treated dyslipidemic patients in Greece). The analysis demonstrated that introducing the SPC leads to an annual budget impact for year five of -395.447€ and a cumulative budget impact of -2.351.952€, equal to savings of approximately 1% in EOPYY budget. The main driver of these savings is the reduction of medication cost due to the lower price of the SPC. Moreover, a further reduction in cardiovascular events through improved adherence could lead to reduction in direct and /or indirect costs. Sensitivity analyses supported the findings of the basic scenario.

CONCLUSIONS

The introduction of a SPC of ezetimibe and rosuvastatin is expected to reduce treatment cost of high-risk patients with hyperlipidemia and support the sustainability of the health care system.