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Cost-effectiveness analysis of low density lipoprotein cholesterol-lowering therapy in hypertensive patients with type 2 diabetes in Korea: single-pill regimen (amlodipine/atorvastatin) versus double-pill regimen (amlodipine+atorvastatin)
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Ji-Hyun Park, Yong-Ho Lee, Su-Kyoung Ko, Bong-Soo Cha
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Epidemiol Health. 2015;37:e2015010. Published online February 22, 2015
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DOI: https://doi.org/10.4178/epih/e2015010
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Abstract
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Abstract
OBJECTIVES Single-pill combination therapy (amlodipine/atorvastatin) might be more effective than double-pill therapy (amlodipine+atorvastatin) in patients with diabetes and concomitant hypertension requiring statin therapy. We compared the cost-effectiveness of a single-pill with that of double-pill for control of low density lipoprotein cholesterol (LDL-C) levels, with the ultimate goal of cardiovascular disease prevention, in these patients using a cost-effectiveness analysis model that considered medication adherence.
METHODS Effectiveness was defined as the percentage (%) attainment of target LDL-C levels (<100 mg/dL) based on adherence for each therapy. Adherence was defined as compliance to medication (≥80% proportion of days covered). A systematic review of the literature was conducted to determine the proportion of patients who were adherent and target goal attainment based on adherence level. The annual medication costs were based on the adherence levels for each regimen. The average cost-effectiveness ratio (ACER) was calculated as the cost per % attainment of the target LDL-C level.
RESULTS The ACER for the single-pill regimen was lower than for the double-pill regimen (4,123 vs. 6,062 Korean won per 1% achievement of target goal). Compared with the double-pill, the medication costs were approximately 32% lower with the single-pill.
CONCLUSION A single-pill for reductions in LDL-C is cost-effective compared with double-pill in hypertensive patients with type 2 diabetes.
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Summary
Korean summary
본 연구는 고혈압을 동반한 당뇨환자에게 혈중지질의 추가적인 관리가 필요한 경우 단일복합제제(Amlodipine/Atorvastatin) 투여와 단일제제 병용 (Amlodipine + Atorvastatin) 투여의 두 대안에서 복약 순응도를 고려한 비용-효과성을 비교 분석하였다. 복약순응도의 차이는 치료결과에도 영향을 미치게 되어 복약순응군에서의 치료효과가 비순응군의 효과보다 더 우수하므로 비용-효과 분석 결과 단일복합제 투여군이 단일제제 병용투여군과 비교하였을때 더 효율적인 대안임을 확인할 수 있다.
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Citations
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