OBJECTIVES: Several studies and clinical guidelines suggest that single-pill combinations (SPCs) are preferred to free combinations (FCs) as they increase treatment benefits by increasing adherence to medication. The objective of this analysis was to assess the budget impact of the introduction of a SPC of atorvastatin, perindopril and amlodipine in the Greek market for the treatment of essential hypertension and/or stable coronary artery disease, in association with primary hypercholesterolaemia or mixed hyperlipidaemia, as substitution therapy in adult patients adequately controlled at the same dose level as in the combination.

METHODS: A budget impact model (BIM) was developed.The analysis was performed from a Greek third-party payer (EOPYY) perspective with a 5-year horizon. Treatment costs and management of adverse events due to non-adherence were considered. The estimation of target population, management and cost of treatment in Greece was based on published data.

RESULTS: A population of 83,291 patients was estimated to receive the FCs. It has been forecasted that this population, and consequently the total treatment cost, will increase by about 2.58% in the next 5 years. The analysis showed that the introduction of a SPC could have an annual budget impact for year 5 of -1.903.639€ and a cumulative budget impact of -6,107,965€, which represents potential savings for EOPYY of about 10,82%. The primary driver of these results is the reduction in medication cost due to the lower price of the SPC. Moreover, a further reduction in cardiovascular events due to better compliance could lead to additional clinical and economic benefits. Sensitivity and scenario analyses supported the findings of the basic scenario.

CONCLUSIONS: The introduction of a SPC at a price lower than that of the FC of the same agents will reduce medication cost and could improve adherence with consequent health benefits, supporting the sustainability of the health care system.