Effect of a single pill concept on clinical and pharmacoeconomic outcomes in cardiovascular diseases

Abstract Aims Our study aimed to assess whether a single pill concept (SPC) is superior to a multi-pill concept (MPC) in reducing cardiovascular (CV) events, all-cause death, and costs in CV patients. Method and results Anonymized medical claims data covering 2012–2018, including patients with hypertension, dyslipidaemia, and CV diseases who started a drug therapy either as SPC or identical MPC were analysed after 1:1-propensity score matching. Hospitalizations with predefined CV events, all-cause mortality, and costs were studied in 25 311 patients with SPC and 25 311 patients with MPC using incidence rate ratios (IRRs) and non-parametric tests for continuous variables. IRRs were significantly lower for SPC: stroke (IRR = 0.77; 95% CI 0.67–0.88; P 0.001), transitory ischaemic attack (IRR = 0.61; 95% CI 0.48–0.78; P 0.001), myocardial infarction (IRR = 0.76; 95% CI 0.63–0.90; P = 0.0016), coronary artery disease (IRR = 0.66; 95% CI 0.57–0.77; P 0.001), heart failure (IRR = 0.59; 95% CI 0.54–0.64; P 0.001), acute renal failure (IRR = 0.54; 95% CI 0.56–0.64; P 0.001), all cause hospitalization (IRR = 0.72; 95% CI 0.71–0.74; P 0.001), CV hospitalization (IRR = 0.63; 95% CI 0.57–0.69; P 0.001), and all-cause mortality (IRR = 0.62; 95% CI 0.57–0.68; P 0.001). Mean time to first events and time to death were also in favour of SPC. Mean total costs were 4708€ for SPC vs. 5.669€ for MPC, respectively (mean ratio 0.830, P 0.001). Conclusion SPC is associated with lower incidence rates of CV events, time to CV events, and all-cause death, and is superior regarding pharmacoeconomic parameters and should therefore become standard of care to improve outcomes and reduce healthcare costs.