Treating hypertension with single pill combinations: a simple strategy to save costs for the patients and payers

OBJECTIVES: Our aim was to compare direct costs for single pill combinations (SPCs) and free-drug combinations for hypertension treatment. METHODS: We focused on Australia as a case study and reviewed total costs, and for the patient and government. We reviewed the Australian "Pharmaceutical Benefits Scheme item drug map" considering different thresholds for the government safety net. Total costs included medicine costs and pharmacy fees. RESULTS: For patients, SPCs always cost less than free-drug combinations, with greatest savings for general patients before reaching safety net (averaging 30%). For government, SPCs cost on average less than free-drug combinations, for Concession Card holders both before (averaging 11%) and after reaching safety net (averaging 26%) and in general patients after safety net (averaging 11%). There was a slight increase in costs (16%) for the government for patients before reaching safety net. All findings were driven by savings in dispensing fees, the main cost of supply, also after the recent introduction of 60-day dispensing. CONCLUSION: Single pill combinations, instead of free-drug combinations, result in cost saving for both patient and government in almost all cases and often these savings are large. SPC cost savings should be factored into prescribing decisions, both for people receiving multiple pills and people starting treatment.