Key result
Single-pill perindopril/bisoprolol linked to ~18% greater adherence and fewer CV hospitalizations versus free-equivalent combination.
Why the study?
Real-world comparative data on drug utilization, hospitalizations, and direct healthcare costs between single-pill and free-equivalent combinations of perindopril and bisoprolol were needed.
Does perindopril and bisoprolol as a single-pill combination improve adherence, reduce hospitalizations, and lower healthcare costs compared to a free-equivalent combination in adult patients?
Observational (n=9,376)
Yes
Does perindopril and bisoprolol as a single-pill combination improve adherence, reduce hospitalizations, and lower healthcare costs compared to a free-equivalent combination in adult patients?
Absolute Event Rate: 45.5% vs 38.6%
p-value: p=<0.001
In a real-world setting, using a single-pill combination of perindopril and bisoprolol significantly improves medication adherence and reduces cardiovascular hospitalizations and healthcare costs compared to taking the drugs separately.
Supports SPC consideration for adherence; extends observational data but leaves causal effects open for RCTs.
INTRODUCTION: The present real-world analysis aims to compare the drug utilization, hospitalizations and direct healthcare costs related to the use of single-pill combination (SPC) or free-equivalent combination (FEC) of perindopril and bisoprolol (PER/BIS) in a large Italian population. METHODS: This observational retrospective analysis was based on administrative databases covering approximately 7 million subjects across Italy. All adult subjects receiving PER/BIS as SPC or FEC between January 2017-June 2020 were included. Subjects were followed for 1 year after the first prescription of PER/BIS as FEC (± 1 month) or SPC. Before comparing the SPC and FEC cohorts, propensity score matching (PSM) was applied to balance the baseline characteristics. Drug utilization was investigated as adherence (defined by the proportion of days covered, PDC) and persistence (evaluated by Kaplan-Meier curves). Hospitalizations and mean annual direct healthcare costs (due to drug prescriptions, hospitalizations and use of outpatient services) were analyzed during follow-up. RESULTS: The original cohort included 11,440 and 6521 patients taking the SPC and FEC PER/BIS combination, respectively. After PSM, two balanced SPC and FEC cohorts of 4688 patients were obtained (mean age 70 years, approximately 50% male, 24% in secondary prevention). The proportion of adherent patients (PDC ≥ 80%) was higher for those on SPC (45.5%) than those on FEC (38.6%), p < 0.001. The PER/BIS combination was discontinued by 35.8% of patients in the SPC cohort and 41.7% in the FEC cohort (p < 0.001). The SPC cohort had fewer cardiovascular (CV) hospitalizations (5.3%) than the free-combination cohort (7.4%), p < 0.001. Mean annual total healthcare costs were lower in the SPC (1999€) than in the FEC (2359€) cohort (p < 0.001). CONCLUSION: In a real-world setting, patients treated with PER/BIS SPC showed higher adherence, lower risk of drug discontinuation, reduced risk of CV hospitalization, and lower healthcare costs than those on FEC of the same drugs.
No takes yet. Share an insight, caveat, or question.
Masi et al. (2023) conducted an observational in Cardiovascular disease / Hypertension (n=9,376). Perindopril/bisoprolol single-pill combination (SPC) vs. Perindopril/bisoprolol free-equivalent combination (FEC) was evaluated on Proportion of highly adherent patients (Proportion of Days Covered ≥ 80%) (p=<0.001). Perindopril and bisoprolol as a single-pill combination significantly improved medication adherence (45.5% vs 38.6%) and reduced cardiovascular hospitalizations compared to a free-equivalent combination.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: