The Journal of Medical Economics reveals that hypertensive patients who are treated with a single tablet regimen (STR) as part of their therapy had a considerable reduction in serious cardiovascular events at a neutral cost as compared with individual component therapies.

The data was based on a retrospective analysis of the UK THIN database and demonstrated that the treatment was cost neutral to the NHS due to the additional drug acquisition costs for STR therapy being offset by a reduction in hospital admissions and initial referral costs for cardiovascular events.

According to Dr Jonathan Belsey’s analysis, over a 5-year period, only 8.3% of hypertensive patients who received a STR as part of their therapy suffered from serious cardiovascular events, compared with 13.6% of patients on individual component therapies.

STR was defined as any combination tablet that incorporated two or more agents from different classes of antihypertensive treatment.

The average annual management cost over a period of five years was calculated at £191.49 per STR patient and at £189.35 for patients treated with single component therapies. Given that the study was based on a retrospective cohort, the researchers were unable to identify the reasons for individual prescriptions, as some prescriptions may have been issued for other reasons rather than hypertension.

The study results support findings from a US meta-analysis, which revealed hospital admissions for cardiovascular events were considerably lower for patients treated with STRs compared with those who received individual component therapy.

Dr Belsey, Health Economist and lead author of the study declared:

“This analysis shows that treatment with the STR resulted in a clinical benefit to patients through the reduction in cardiovascular events, and a benefit to the NHS by reducing healthcare costs associated with complications of poor blood pressure control, particularly heart attacks and stroke.”

40% of hypertensive patients in the UK failed to achieve a blood pressure target of 140/90 mmHg in 2010. There are various potential explanations for failing to achieve clinical targets; one major factor is the likelihood of poor adherence to therapy. STRs managed to improve treatment adherence by up to 25%, in comparison with individual component therapies, and those adhering to their prescribed treatment regime have better blood pressure control, improved clinical outcomes and have a lower risk of being referred or hospitalized.

In the UK, nearly 2 million people are prescribed with three or more treatments for their hypertension. However, 50 to 80% of these fail to adhere to the regime their doctor prescribed, with the result that a percentage of these individuals may still suffer from uncontrolled hypertension.

Stroke is the third most common cause of mortality within the UK, and the biggest risk of stroke is uncontrolled hypertension. Each year the NHS pays about £2.8 billion in medical costs for stroke, whilst the economic costs of stroke runs into an estimated £7 billion per year.

Graham MacGregor, Professor of Cardiovascular Medicine and Chairman of the Blood Pressure Association explained:

“Many patients suffering from hypertension struggle with adherence because they have to remember to take numerous tablets everyday to treat their condition. STRs offer a simplified treatment regimen and their wider use could help with adherence, no doubt leading to better blood pressure control and helping to reduce the risk of cardiovascular disease and stroke.”

Written By Petra Rattue