Cost-effectiveness and public health benefit of secondary cardiovascular disease prevention from improved adherence using a polypill in the UK

BMJ Open

Volumn 5, Issue 5, 2015, Pages

  Becerra, Virginia ^a   Gracia, Alfredo ^a   Desai, Kamal ^b   Abogunrin, Seye ^b   Brand, Sarah ^c   Chapman, Ruth ^b   Alonso, Fernando García ^a   Fuster, Valentín ^d,e   Sanz, Ginés ^e  

^a Ferrer Grupo   (Spain)

^b EVIDERA   (United Kingdom)

^c EVIDERA   (United States)

^d MOUNT SINAI MEDICAL CENTER   (United States)

^e CENTRO NACIONAL DE INVESTIGACIONES CARDIOVASCULARES CNIC   (Spain)

Author keywords

[No Author keywords available]

Indexed keywords

ACETYLSALICYLIC ACID; ATORVASTATIN; RAMIPRIL; CARDIOVASCULAR AGENT;

ADULT; ARTICLE; CARDIOVASCULAR DISEASE; COST EFFECTIVENESS ANALYSIS; DRUG COST; FEMALE; HEALTH CARE UTILIZATION; HEART INFARCTION; HIDDEN MARKOV MODEL; HUMAN; MALE; MEDICATION COMPLIANCE; MIDDLE AGED; PUBLIC HEALTH; QUALITY OF LIFE; SECONDARY PREVENTION; SYSTEMATIC REVIEW; UNITED KINGDOM; AGED; CARDIOVASCULAR DISEASES; COMBINATION DRUG THERAPY; COST BENEFIT ANALYSIS; ECONOMIC MODEL; ECONOMICS; MARKOV CHAIN; POLYPHARMACY; STATISTICS AND NUMERICAL DATA;

AGED; CARDIOVASCULAR AGENTS; CARDIOVASCULAR DISEASES; COST-BENEFIT ANALYSIS; DRUG THERAPY, COMBINATION; HUMANS; MARKOV CHAINS; MEDICATION ADHERENCE; MODELS, ECONOMIC; POLYPHARMACY; PUBLIC HEALTH;

EID: 84930226063     PISSN: None     EISSN: 20446055     Source Type: Journal    
DOI: 10.1136/bmjopen-2014-007111     Document Type: Article

References (51)

1. Dalton AR, Soljak M, Samarasundera E, et al. Prevalence of cardiovascular disease risk amongst the population eligible for the NHS Health Check Programme. Eur J Prev Cardiol 2013;20:142-50.
2. Neil HA, Perera R, Armitage JM, et al. Estimated 10-year cardiovascular risk in a British population: results of a national screening project. Int J Clin Pract 2008;62:1322-31.
3. Wang YC, McPherson K, Marsh T, et al. Health and economic burden of the projected obesity trends in the USA and the UK. Lancet 2011;378:815-25.
4. National Institute for Health and Care Excellence (NICE). MI-secondary prevention: secondary prevention in primary and secondary care for patients following a myocardial infarction [CG172]. London, UK: National Institute for Health and Care Excellence, 2013. http://guidance.nice.org.uk/CG172 (accessed Jun 2014).
5. Lafeber M, Spiering W, van der Graaf Y, et al. The combined use of aspirin, a statin, and blood pressure-lowering agents (polypill components) and the risk of vascular morbidity and mortality in patients with coronary artery disease. Am Heart J 2013;166:282-89.e1.
6. DeWilde S, Carey IM, Richards N, et al. Trends in secondary prevention of ischaemic heart disease in the UK 1994 2005: use of individual and combination treatment. Heart 2008;94:83-8.
7. Ramsay SE, Whincup PH, Wannamethee SG, et al. Missed opportunities for secondary prevention of cerebrovascular disease in elderly British men from 1999 to 2005: a population-based study. J Public Health (Oxf) 2007;29:251-7.
8. Kotseva K, Jennings CS, Turner EL, et al. ASPIRE-2-PREVENT: a survey of lifestyle, risk factor management and cardioprotective medication in patients with coronary heart disease and people at high risk of developing cardiovascular disease in the UK. Heart 2012;98:865-71.
9. Sheppard JP, Fletcher K, McManus RJ, et al. Maybe it's time for something a little different? The extent to which current pharmacotherapy practice conforms to national guidelines for stroke and cardiovascular disease prevention. Int J Stroke 2013;8:7.
10. Newby LK, LaPointe NM, Chen AY, et al. Long-term adherence to evidence-based secondary prevention therapies in coronary artery disease. Circulation 2006;113:203-12.
11. Wei L, Fahey T, MacDonald TM. Adherence to statin or aspirin or both in patients with established cardiovascular disease: exploring healthy behaviour vs. drug effects and 10-year follow-up of outcome. Br J Clin Pharmacol 2008;66:110-16.
12. Cascini S, Kirchmayer U, Bauleo L, et al. Evidence based drug therapy and medium-long-term outcomes in very old patients after acute myocardial infarction. Pharmacoepidemiol Drug Saf 2012;21:235.
13. Cotter G, Shemesh E, Zehavi M, et al. Lack of aspirin effect: aspirin resistance or resistance to taking aspirin? Am Heart J 2004;147:293-300.
14. Garcia Rodriguez LA, Cea Soriano L, Hill C, et al. Increased risk of stroke after discontinuation of acetylsalicylic acid: a UK primary care study. Neurology 2011;76:740-6.
15. Rajagopalan S, Vieira JL, Alemao E, et al. The impact of lipid-lowering treatment patterns on LDL-C reduction and goal attainment in secondary prevention in Germany. Prev Control 2006;2:15-26.
16. Jin J, Sklar GE, Min Sen Oh V, et al. Factors affecting therapeutic compliance: a review from the patient's perspective. Ther Clin Risk Manag 2008;4:269-86.
17. Perk J, De Backer G, Gohlke H, et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012). The Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur Heart J 2012;33:1635-701.
18. Lafeber M, Spiering W, Singh K, et al. The cardiovascular polypill in high-risk patients. Eur J Prev Cardiol 2012;19:1234-42.
19. Muntner P, Mann D, Wildman RP, et al. Projected impact of polypill use among US adults: medication use, cardiovascular risk reduction, and side effects. Am Heart J 2011;161:719-25.
20. Sanz G, Fuster V. Fixed-dose combination therapy and secondary cardiovascular prevention: rationale, selection of drugs and target population. Nat Clin Pract Cardiovasc Med 2009;6:101-10.
21. Wald NJ, Law MR. A strategy to reduce cardiovascular disease by more than 80%. BMJ 2003;326:1419-23.
22. Zeymer U, Junger C, Zahn R, et al. Effects of a secondary prevention combination therapy with an aspirin, an ACE inhibitor and a statin on 1-year mortality of patients with acute myocardial infarction treated with a beta-blocker. Support for a polypill approach. Curr Med Res Opin 2011;27:1563-70.
23. National Institute for Health and Care Excellence (NICE). Guide to the methods of technology appraisal [PMG9]. London, UK: National Institute for Health and Care Excellence, 2013. http://publications.nice.org.uk/guide-to-the-methods-of-technology-appraisal-2013-pmg9 (accessed 14 Jul 2014).
24. Personal Social Services Research Unit (PSSRU). Unit costs of health & social care 2013. 2014. http://www.pssru.ac.uk/project-pages/unit-costs/2013/ (accessed 14 Jul 2014).
25. Thom S, Poulter N, Field J, et al. Effects of a fixed-dose combination strategy on adherence and risk factors in patients with or at high risk of CVD: the UMPIRE randomized clinical trial. JAMA 2013;310:918-29.
26. Patel A, Cass A, Peiris D, et al. A pragmatic randomized trial of a polypill-based strategy to improve use of indicated preventive treatments in people at high cardiovascular disease risk. Eur J Prev Cardiol 2014. Published Online First 27 Mar 2014. doi: 10.1177/2047487314530382
27. Husereau D, Drummond M, Petrou S, et al. Consolidated Health Economic Evaluation Reporting Standards (CHEERS) - explanation and elaboration: a report of the ISPOR Health Economic Evaluation Publication Guidelines Good Reporting Practices Task Force. Value Health 2013;16:231-50.
28. de Vries ST, Keers JC, Visser R, et al. Medication beliefs, treatment complexity, and non-adherence to different drug classes in patients with type 2 diabetes. J Psychosom Res 2014;76:134-8.
29. Ross A, Jami H, Young HA, et al. Sync and swim: the impact of medication consolidation on adherence in Medicaid patients. J Prim Care Community Health 2013;4:240-4.
30. Gaziano TA, Opie LH, Weinstein MC. Cardiovascular disease prevention with a multidrug regimen in the developing world: a cost-effectiveness analysis. Lancet 2006;368:679-86.
31. Health and Social Care Information Centre. Prescription cost analysis England 2013. Leeds, UK: Health and Social Care Information Centre, 2014. http://www.hscic.gov.uk/catalogue/PUB13887/pres-cost-anal-eng-2013-rep.pdf (accessed 14 Jul 2014).
32. Kotseva K, Wood D, De Backer G, et al. EUROASPIRE III: a survey on the lifestyle, risk factors and use of cardioprotective drug therapies in coronary patients from 22 European countries. Eur J Cardiovasc Prev Rehabil 2009;16:121-37.
33. Ara R, Pandor A, Stevens J, et al. Prescribing high-dose lipid-lowering therapy early to avoid subsequent cardiovascular events: is this a cost-effective strategy? Eur J Prev Cardiol 2012;19:474-83.
34. De Smedt D, Kotseva K, De Bacquer D, et al. Cost-effectiveness of optimizing prevention in patients with coronary heart disease: the EUROASPIRE III health economics project. Eur Heart J 2012;33:2865-72.
35. Heeg B, Damen J, Van Hout B. Oral antiplatelet therapy in secondary prevention of cardiovascular events: an assessment from the payer's perspective. Pharmacoeconomics 2007;25:1063-82.
36. Scuffham PA, Chaplin S. An economic evaluation of fluvastatin used for the prevention of cardiac events following successful first percutaneous coronary intervention in the UK. Pharmacoeconomics 2004;22:525-35.
37. Scuffham PA, Chaplin S. A cost-effectiveness analysis of fluvastatin in patients with diabetes after successful percutaneous coronary intervention. Clin Ther 2005;27:1467-77.
38. Selak V, Elley CR, Bullen C, et al. Effect of fixed dose combination treatment on adherence and risk factor control among patients at high risk of cardiovascular disease: randomised controlled trial in primary care. BMJ 2014;348:g3318.
39. British Heart Foundation. Cardiovascular disease statistics 2014. London, UK: British Heart Foundation, 2014. http://www.bhf.org.uk/research/heart-statistics/morbidity/prevalence.asp (accessed 14 Jul 2014).
40. Smolina K, Wright FL, Rayner M, et al. Incidence and 30-day case fatality for acute myocardial infarction in England in 2010: national-linked database study. Eur J Public Health 2012;22:848-53.
41. Office for National Statistics (ONS). Population projections. 2014. http://www.ons.gov.uk/ons/taxonomy/index.html?nscl=Population+Projections (accessed Jun 2014).
42. Department of Health (UK). National schedule of reference costs: spell costs. 2013. https://www.gov.uk/government/publications/nhs-reference-costs-2012-to-2013 (accessed 14 Jul 2014).
43. Saka RO, McGuire A, Wolfe CDA. Economic burden of stroke in England. London, UK: University of London, 2005. http://www.nao.org.uk/wp-content/uploads/2005/11/0506452-economic-analysis.pdf (accessed 12 Mar 2015).
44. Taylor DC, Pandya A, Thompson D, et al. Cost-effectiveness of intensive atorvastatin therapy in secondary cardiovascular prevention in the United Kingdom, Spain, and Germany, based on the Treating to New Targets study. Eur J Health Econ 2009;10:255-65.
45. Ward S, Lloyd Jones M, Pandor A, et al. A systematic review and economic evaluation of statins for the prevention of coronary events. Health Technol Assess 2007;11:1-160, iii-iv.
46. Choudhry NK, Patrick AR, Antman EM, et al. Cost-effectiveness of providing full drug coverage to increase medication adherence in post-myocardial infarction Medicare beneficiaries. Circulation 2008;117:1261-8.
47. Saha SA, Molnar J, Arora RR. Tissue ACE inhibitors for secondary prevention of cardiovascular disease in patients with preserved left ventricular function: a pooled meta-analysis of randomized placebo-controlled trials. J Cardiovasc Pharmacol Ther 2007;12:192-204.
48. Baigent C, Blackwell L, Collins R, Antithrombotic Trialists (ATT) Collaboration. Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet 2009;373:1849-60.
49. Yusuf S, Sleight P, Dagenais G. The HOPE (Heart Outcomes Prevention Evaluation) Study. FDA briefing: a large, randomized trial of the ACE inhibitor, ramipril, and vitamin E in patients at high risk of cardiovascular events. Silver Spring, MD: U.S. Food and Drug Administration, 2000. http://www.fda.gov/ohrms/dockets/ac/00/backgrd/3612b1d.pdf (accessed 14 Jul 2014).
50. Vale N, Nordmann AJ, Schwartz GG, et al. Statins for acute coronary syndrome. Cochrane Database Syst Rev 2011;(6):CD006870.
51. British National Formulary. 2014. http://www.bnf.org/bnf/index.htm (accessed 14 Jul 2014).