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Switching to Single-Pill Combination Enhances Adherence to Cardiovascular Treatment in Italy

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In a comprehensive assessment of real-world data from Italy, it has been found that patients adhering to cardiovascular treatments involving a single-pill combination of rosuvastatin and ezetimibe (ROS/EZE) demonstrate significantly improved adherence compared to those using multiple pills. This study taps into administrative databases covering a large population and provides critical insights into enhancing adherence through simplified medication regimens.

Study Overview

A retrospective analysis aimed to determine the impact of transitioning from a free multi-pill combination to a single-pill combination of ROS/EZE on patient adherence. The study utilized data from approximately seven million health-assisted residents in Italy, focusing on adults who received the single-pill combination between January 2010 and June 2020, with follow-up extending to 2021. The key metric for evaluating adherence was the proportion of days covered (PDC), which measures the percentage of days a patient had access to their prescribed medication.

Key Findings

The analysis included 1,219 patients, predominantly male (61.1%) with an average age of 66.2 years. A significant majority had cardiovascular comorbidities (83.3%), diabetes (26.4%), or both (16.2%). The study revealed a marked improvement in adherence rates among patients who switched to the single-pill combination, with 75.2% achieving high adherence (PDC > 75%) compared to just 51.8% in the multi-pill group (p

From a market access perspective, the findings highlight the importance of simplifying treatment regimens to improve patient adherence, which could translate into better health outcomes and reduced healthcare costs. Ensuring easy access to single-pill combinations could be a strategic approach for healthcare providers and pharmaceutical companies aiming to optimize therapeutic efficacy and patient satisfaction.

Concrete Inferences

Inferences and Implications:

• Enhanced adherence with single-pill combinations can lead to better clinical outcomes and potentially lower cardiovascular events.
• Simplified medication regimens may reduce the overall healthcare burden by decreasing the frequency of hospital admissions and medical interventions due to non-adherence.
• Market access strategies should prioritize the availability and affordability of single-pill combinations to maximize public health benefits.

In conclusion, this real-world analysis suggests that switching from a multi-pill regimen to a single-pill combination of ROS/EZE significantly improves patient adherence. Such findings could play a crucial role in shaping future policies and market access strategies focused on optimizing cardiovascular treatment adherence.

Original Article:

Adv Ther. 2024 Jul 4. doi: 10.1007/s12325-024-02916-8. Online ahead of print.

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ABSTRACT

INTRODUCTION: Adherence to cardiovascular drug treatment can significantly benefit from a reduced pill burden, but data on this matter derived from real-life settings are currently scanty. This analysis assessed the possible changes in adherence in patients treated with rosuvastatin and ezetimibe (ROS/EZE) as free multi-pill combination who switched to ROS/EZE as single-pill combination in the setting of real clinical practice in Italy.

METHODS: A retrospective analysis was conducted on the administrative databases for a catchment area of about seven million health-assisted residents. Adults receiving ROS/EZE as a single-pill combination from January 2010 to June 2020 (followed up to 2021) were identified. The date of the first prescription of single-pill combination of ROS/EZE was considered as the index date. The analysis included the users of ROS/EZE as a free combination during the year before the index date. Baseline demographic and clinical characteristics were collected during the period of data availability prior to the index date. Adherence to therapy was evaluated as proportion of days covered (PDC), namely the percentage of days during which a patient had access to medication, in the 12-month interval preceding or following the index date (PDC < 25% non-adherence; PDC = 25-75% partial adherence; PDC > 75% adherence).

RESULTS: A total of 1219 patients (61.1% male, aged 66.2 ± 10.4 years) were included. Cardiovascular comorbidities were found in 83.3% of them, diabetes in 26.4%, and a combination of both in 16.2%. Single-pill combination of ROS/EZE was associated with a higher proportion of adherent patients compared to free-pill combination (75.2% vs 51.8%, p < 0.001).

CONCLUSIONS: This real-world analysis suggested that switching from a regimen based on separate pills to one based on a single-pill combination resulted in improved adherence to ROS/EZE therapy.

PMID:38963586 | DOI:10.1007/s12325-024-02916-8

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