Weisser Burkhard, Wassmann Sven, Predel Hans-Georg, Schmieder Roland E, Gillessen Anton, Wilke Thomas, Blettenberg Jörg, Randerath Olaf, Mevius Antje, Böhm Michael
Institute of Sports Science, Christian-Albrechts-University of Kiel, Kiel 24098, Germany.
Cardiology Pasing, Munich, Germany.
Eur Heart J Cardiovasc Pharmacother. 2025 Jan 11;10(8):686-693. doi: 10.1093/ehjcvp/pvae059.
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.
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).
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.
我们的研究旨在评估单片复方制剂（SPC）在降低心血管疾病（CV）患者的心血管事件、全因死亡和成本方面是否优于多片复方制剂（MPC）。
在进行1:1倾向得分匹配后，分析了2012年至2018年的匿名医疗理赔数据，包括开始接受SPC或相同MPC药物治疗的高血压、血脂异常和CV疾病患者。使用发病率比（IRR）和连续变量的非参数检验，对25311例SPC患者和25311例MPC患者的预定义CV事件住院、全因死亡率和成本进行了研究。SPC的IRR显著更低：中风（IRR = 0.77；95% CI 0.67 - 0.88；P < 0.001）、短暂性脑缺血发作（IRR = 0.61；95% CI 0.48 - 0.78；P < 0.001）、心肌梗死（IRR = 0.76；95% CI 0.63 - 0.90；P = 0.0016）、冠状动脉疾病（IRR = 0.66；95% CI 0.57 - 0.77；P < 0.001）、心力衰竭（IRR = 0.59；95% CI 0.54 - 0.64；P < 0.001）、急性肾衰竭（IRR = 0.54；95% CI 0.56 - 0.64；P < 0.001）、全因住院（IRR = 0.72；95% CI 0.71 - 0.74；P < 0.001）、CV住院（IRR = 0.63；95% CI 0.57 - 0.69；P < 0.001）和全因死亡率（IRR = 0.6, 2；95% CI 0.57 - 0.68；P < 0.001）。首次事件的平均时间和死亡时间也有利于SPC。SPC的平均总成本分别为4708欧元，而MPC为5669欧元（平均比率0.830，P < 0.001）。
SPC与较低的CV事件发生率、发生CV事件的时间和全因死亡相关，在药物经济学参数方面更具优势，因此应成为改善治疗结果和降低医疗成本的标准治疗方案。
