Key result
CNIC-Polypill as secondary prevention of ASCVD was associated with a lower 24-month incidence of cardiovascular events compared to monocomponents (19.8% vs 23.3%; p<0.01) and reduced healthcare costs.
Why the study?
To estimate healthcare resource utilization, costs, and cost-effectiveness of the CNIC-Polypill for secondary prevention of ASCVD compared to other treatments in Spanish clinical practice.
Does the CNIC-Polypill (aspirin+atorvastatin+ramipril) reduce cardiovascular events and healthcare costs compared to separate components or other therapies in patients requiring secondary prevention of ASCVD?
Observational (n=6,456)
Does the CNIC-Polypill (aspirin+atorvastatin+ramipril) reduce cardiovascular events and healthcare costs compared to separate components or other therapies in patients requiring secondary prevention of ASCVD?
The use of a cardiovascular polypill (aspirin, atorvastatin, ramipril) for secondary prevention of ASCVD is associated with fewer recurrent cardiovascular events and lower healthcare costs compared to multiple pill regimens.
Answers are grounded in this paper and cite their sources.
May support polypill in ASCVD secondary prevention; hypothesis-generating and requires randomized confirmation.
Purpose: The aim of this study was to estimate health-care resources utilization, costs and cost-effectiveness associated with the treatment with CNIC-Polypill as secondary prevention of atherosclerotic cardiovascular disease (ASCVD) compared to other treatments, in clinical practice in Spain. Patients and Methods: An observational, retrospective study was performed using medical records (economic results [healthcare perspective], NEPTUNO-study; BIG-PAC-database) of patients who initiated secondary prevention between 2015 and 2018. Patients were followed up to 2 years (maximum). Four cohorts were balanced with a propensity-score-matching (PSM): 1) CNIC-Polypill (aspirin+atorvastatin+ramipril), 2) Monocomponents (same separate drugs), 3) Equipotent (equipotent drugs) and 4) Other therapies ([OT], other cardiovascular drugs). Incidence of cardiovascular events, health-care resources utilization and healthcare and non-healthcare costs (2020 Euros) were compared. Incremental cost-effectiveness ratios per cardiovascular event avoided were estimated. Results: After PSM, 1614 patients were recruited in each study cohort. The accumulated incidence of cardiovascular events during the 24-month follow-up was lower in the CNIC-Polypill cohort vs the other cohorts (19.8% vs Monocomponents: 23.3%, Equipotent: 25.5% and OT: 26.8%; p<0.01). During the follow-up period, the CNIC-Polypill cohort also reduced the health-care resources utilization per patient compared to the other cohorts, particularly primary care visits (16.6 vs Monocomponents: 18.7, Equipotent: 18.9 and OT: 21.0; p<0.001) and hospitalization days (2.3 vs Monocomponents: 3.4, Equipotent: 3.7 and OT: 4.0; p<0.001). The treatment cost in the CNIC-Polypill cohort was lower than that in the other cohorts (€4668 vs Monocomponents: €5587; Equipotent: €5682 and OT: €6016; p<0.001) (Difference: -€919, -€1014 and -€1348, respectively). Due to the reduction of cardiovascular events and costs, the CNIC-Polypill is a dominant alternative compared to the other treatments. Conclusion: CNIC-Polypill reduces recurrent major cardiovascular events and costs, being a cost-saving strategy as secondary prevention of ASCVD.
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Cordero et al. (2023) conducted an observational in Atherosclerotic cardiovascular disease (ASCVD) (n=6,456). CNIC-Polypill (aspirin+atorvastatin+ramipril) vs. Monocomponents, equipotent drugs, or other cardiovascular therapies was evaluated on Incidence of cardiovascular events (p=<0.01). CNIC-Polypill as secondary prevention of ASCVD was associated with a lower 24-month incidence of cardiovascular events compared to monocomponents (19.8% vs 23.3%; p<0.01) and reduced healthcare costs.
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