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Economic Burden Associated with the Treatment with a Cardiovascular Polypill in Secondary Prevention in Spain: Cost-Effectiveness Results of the NEPTUNO Study

  • Identification data

    Identifier: imarina:9330066
    Authors:
    Cordero, AGonzález-Gallarza, RDMasana, LFuster, VCastellano, JMOlivar, JERZsolt, ISicras-Mainar, AJuanatey, JRG
    Abstract:
    Purpose: The aim of this study was to estimate health-care resources utilization, costs and cost-effectiveness associated with the treatment with CNIC-Polypill as secondary prevention of atherosclerotic cardiovascular disease (ASCVD) compared to other treatments, in clinical practice in Spain.Patients and Methods: An observational, retrospective study was performed using medical records (economic results [health-care perspective], NEPTUNO-study; BIG-PAC-database) of patients who initiated secondary prevention between 2015 and 2018. Patients were followed up to 2 years (maximum). Four cohorts were balanced with a propensity-score-matching (PSM): 1) CNIC-Polypill (aspirin+atorvastatin+ramipril), 2) Monocomponents (same separate drugs), 3) Equipotent (equipotent drugs) and 4) Other therapies ([OT], other cardiovascular drugs). Incidence of cardiovascular events, health-care resources utilization and healthcare and non-healthcare costs (2020 Euros) were compared. Incremental cost-effectiveness ratios per cardiovascular event avoided were estimated.Results: After PSM, 1614 patients were recruited in each study cohort. The accumulated incidence of cardiovascular events during the 24-month follow-up was lower in the CNIC-Polypill cohort vs the other cohorts (19.8% vs Monocomponents: 23.3%, Equipotent: 25.5% and OT: 26.8%; p<0.01). During the follow-up period, the CNIC-Polypill cohort also reduced the health-care resources utilization per patient compared to the other cohorts, particularly primary care visits (16.6 vs Monocomponents: 18.7, Equipotent: 18.9 and OT: 21.0; p<0.001) and hospitalization days (2.3 vs Monocomponents: 3.4, Equipotent: 3.7 and OT: 4.0; p<0.001). The treatment cost in the CNIC-Polypill cohort was lower than that in the other cohorts (euro4668 vs Monocomp
  • Others:

    Author, as appears in the article.: Cordero, A; González-Gallarza, RD; Masana, L; Fuster, V; Castellano, JM; Olivar, JER; Zsolt, I; Sicras-Mainar, A; Juanatey, JRG
    Department: Medicina i Cirurgia
    URV's Author/s: Masana Marín, Luis
    Keywords: Use of healthcare resources Strategy Spain Secondary prevention Risk Healthcare costs Health Global burden Fixed-dose combination European-society Epidemiology Dyslipidemia Disease Cnic-polypill Cardiovascular events Adherence
    Abstract: Purpose: The aim of this study was to estimate health-care resources utilization, costs and cost-effectiveness associated with the treatment with CNIC-Polypill as secondary prevention of atherosclerotic cardiovascular disease (ASCVD) compared to other treatments, in clinical practice in Spain.Patients and Methods: An observational, retrospective study was performed using medical records (economic results [health-care perspective], NEPTUNO-study; BIG-PAC-database) of patients who initiated secondary prevention between 2015 and 2018. Patients were followed up to 2 years (maximum). Four cohorts were balanced with a propensity-score-matching (PSM): 1) CNIC-Polypill (aspirin+atorvastatin+ramipril), 2) Monocomponents (same separate drugs), 3) Equipotent (equipotent drugs) and 4) Other therapies ([OT], other cardiovascular drugs). Incidence of cardiovascular events, health-care resources utilization and healthcare and non-healthcare costs (2020 Euros) were compared. Incremental cost-effectiveness ratios per cardiovascular event avoided were estimated.Results: After PSM, 1614 patients were recruited in each study cohort. The accumulated incidence of cardiovascular events during the 24-month follow-up was lower in the CNIC-Polypill cohort vs the other cohorts (19.8% vs Monocomponents: 23.3%, Equipotent: 25.5% and OT: 26.8%; p<0.01). During the follow-up period, the CNIC-Polypill cohort also reduced the health-care resources utilization per patient compared to the other cohorts, particularly primary care visits (16.6 vs Monocomponents: 18.7, Equipotent: 18.9 and OT: 21.0; p<0.001) and hospitalization days (2.3 vs Monocomponents: 3.4, Equipotent: 3.7 and OT: 4.0; p<0.001). The treatment cost in the CNIC-Polypill cohort was lower than that in the other cohorts (euro4668 vs Monocomponents: euro5587; Equipotent: euro5682 and OT: euro6016; p<0.001) (Difference:-euro919,-euro1014 and-euro1348, respectively). Due to the reduction of cardiovascular events and costs, the CNIC-Polypill is a dominant alternative compared to the other treatments.Conclusion: CNIC-Polypill reduces recurrent major cardiovascular events and costs, being a cost-saving strategy as secondary prevention of ASCVD.
    Thematic Areas: Interdisciplinar Health policy Health care sciences & services Economics, econometrics and finance (miscellaneous) Ciencias sociales
    licence for use: https://creativecommons.org/licenses/by/3.0/es/
    Author's mail: luis.masana@urv.cat
    Author identifier: 0000-0002-0789-4954
    Record's date: 2024-08-03
    Papper version: info:eu-repo/semantics/publishedVersion
    Link to the original source: https://www.dovepress.com/economic-burden-associated-with-the-treatment-with-a-cardiovascular-po-peer-reviewed-fulltext-article-CEOR
    Licence document URL: https://repositori.urv.cat/ca/proteccio-de-dades/
    Papper original source: Clinicoeconomics And Outcomes Research. 15 559-571
    APA: Cordero, A; González-Gallarza, RD; Masana, L; Fuster, V; Castellano, JM; Olivar, JER; Zsolt, I; Sicras-Mainar, A; Juanatey, JRG (2023). Economic Burden Associated with the Treatment with a Cardiovascular Polypill in Secondary Prevention in Spain: Cost-Effectiveness Results of the NEPTUNO Study. Clinicoeconomics And Outcomes Research, 15(), 559-571. DOI: 10.2147/CEOR.S396290
    Article's DOI: 10.2147/CEOR.S396290
    Entity: Universitat Rovira i Virgili
    Journal publication year: 2023
    Publication Type: Journal Publications
  • Keywords:

    Economics, Econometrics and Finance (Miscellaneous),Health Care Sciences & Services,Health Policy
    Use of healthcare resources
    Strategy
    Spain
    Secondary prevention
    Risk
    Healthcare costs
    Health
    Global burden
    Fixed-dose combination
    European-society
    Epidemiology
    Dyslipidemia
    Disease
    Cnic-polypill
    Cardiovascular events
    Adherence
    Interdisciplinar
    Health policy
    Health care sciences & services
    Economics, econometrics and finance (miscellaneous)
    Ciencias sociales
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