Cost-effectiveness of a fixed dose combination (polypill) in secondary prevention of cardiovascular diseases in India: Within-trial cost-effectiveness analysis of the UMPIRE trial.

Singh, K; Crossan, C; Laba, T-L; Roy, A; Hayes, A; Salam, A; Jan, S; Lord, J; Tandon, N; Rodgers, A; Patel, A; Thom, S; Prabhakaran, D

Cost-effectiveness of a fixed dose combination (polypill) in secondary prevention of cardiovascular diseases in India: Within-trial cost-effectiveness analysis of the UMPIRE trial.

Singh, K Crossan, C Laba, T-L Roy, A Hayes, A Salam, A Jan, S Lord, J Tandon, N Rodgers, A Patel, A Thom, S Prabhakaran, D

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Publisher:: ELSEVIER IRELAND LTD
Publication Type:: Journal Article
Citation:: Int J Cardiol, 2018, 262, pp. 71-78
Issue Date:: 2018-07-01

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Field	Value	Language
dc.contributor.author	Singh, K
dc.contributor.author	Crossan, C
dc.contributor.author	Laba, T-L
dc.contributor.author	Roy, A
dc.contributor.author	Hayes, A
dc.contributor.author	Salam, A
dc.contributor.author	Jan, S
dc.contributor.author	Lord, J
dc.contributor.author	Tandon, N
dc.contributor.author	Rodgers, A
dc.contributor.author	Patel, A
dc.contributor.author	Thom, S
dc.contributor.author	Prabhakaran, D
dc.date.accessioned	2022-09-11T21:56:39Z
dc.date.available	2018-03-16
dc.date.available	2022-09-11T21:56:39Z
dc.date.issued	2018-07-01
dc.identifier.citation	Int J Cardiol, 2018, 262, pp. 71-78
dc.identifier.issn	0167-5273
dc.identifier.issn	1874-1754
dc.identifier.uri	http://hdl.handle.net/10453/161701
dc.description.abstract	BACKGROUND: The Use of Multidrug Pill In Reducing cardiovascular Events (UMPIRE) trial, showed that access to a cardiovascular polypill (aspirin, statin and two blood pressure lowering drugs) significantly improved adherence, lowered systolic blood pressure (SBP) and low-density lipoprotein cholesterol (LDLc) in patients with or at high risk of cardiovascular disease (CVD). We aimed to analyze the within-trial cost-effectiveness of the polypill strategy versus usual care in India. METHODS: Relative effectiveness and costs of polypill versus usual care groups in UMPIRE were estimated from the health sector perspective. Only direct medical costs were considered. The effectiveness of the polypill was reported as a percentage increase in adherence and mean reductions in SBP, and LDL-c, over the 15-month trial period. Healthcare resource utilization and costs were collected for each patient during the trial. Polypill price was constructed using a range of scenarios: $0.06-$0.94/day. The cost-effectiveness of the polypill was measured as the additional cost for 10% increase in adherence, and per unit reduction in SBP and LDL-c. RESULTS: Overall, the mean cost per patient was significantly lower with the polypill strategy (-$203 per person, (95% CI: -286, -119, p < 0.01). In scenario analyses that varied polypill price assumptions, incremental cost-effectiveness ratios for a polypill strategy ranged between cost-saving to $75 per 10% increase in adherence for polypill price of $0.94 per day. CONCLUSIONS: The polypill strategy was cost-saving compared to usual care among patients with or at high risk of CVD in India.
dc.format	Print-Electronic
dc.language	eng
dc.publisher	ELSEVIER IRELAND LTD
dc.relation.ispartof	Int J Cardiol
dc.relation.isbasedon	10.1016/j.ijcard.2018.03.082
dc.rights	info:eu-repo/semantics/closedAccess
dc.subject	1102 Cardiorespiratory Medicine and Haematology, 1117 Public Health and Health Services
dc.subject.classification	Cardiovascular System & Hematology
dc.subject.mesh	Anticholesteremic Agents
dc.subject.mesh	Antihypertensive Agents
dc.subject.mesh	Cardiovascular Diseases
dc.subject.mesh	Cost of Illness
dc.subject.mesh	Cost-Benefit Analysis
dc.subject.mesh	Drug Therapy, Combination
dc.subject.mesh	Female
dc.subject.mesh	Follow-Up Studies
dc.subject.mesh	Humans
dc.subject.mesh	Hydroxymethylglutaryl-CoA Reductase Inhibitors
dc.subject.mesh	Incidence
dc.subject.mesh	India
dc.subject.mesh	Male
dc.subject.mesh	Medication Adherence
dc.subject.mesh	Middle Aged
dc.subject.mesh	Platelet Aggregation Inhibitors
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Risk Factors
dc.subject.mesh	Secondary Prevention
dc.subject.mesh	Humans
dc.subject.mesh	Cardiovascular Diseases
dc.subject.mesh	Antihypertensive Agents
dc.subject.mesh	Platelet Aggregation Inhibitors
dc.subject.mesh	Anticholesteremic Agents
dc.subject.mesh	Hydroxymethylglutaryl-CoA Reductase Inhibitors
dc.subject.mesh	Drug Therapy, Combination
dc.subject.mesh	Incidence
dc.subject.mesh	Risk Factors
dc.subject.mesh	Retrospective Studies
dc.subject.mesh	Follow-Up Studies
dc.subject.mesh	Cost of Illness
dc.subject.mesh	Middle Aged
dc.subject.mesh	Cost-Benefit Analysis
dc.subject.mesh	India
dc.subject.mesh	Female
dc.subject.mesh	Male
dc.subject.mesh	Medication Adherence
dc.subject.mesh	Secondary Prevention
dc.title	Cost-effectiveness of a fixed dose combination (polypill) in secondary prevention of cardiovascular diseases in India: Within-trial cost-effectiveness analysis of the UMPIRE trial.
dc.type	Journal Article
utslib.citation.volume	262
utslib.location.activity	Netherlands
utslib.for	1102 Cardiorespiratory Medicine and Haematology
utslib.for	1117 Public Health and Health Services
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Health
pubs.organisational-group	/University of Technology Sydney/Strength - CHERE - Centre for Health Economics Research and Evaluation
utslib.copyright.status	closed_access	*
dc.date.updated	2022-09-11T21:56:38Z
pubs.publication-status	Published
pubs.volume	262

Abstract:

BACKGROUND: The Use of Multidrug Pill In Reducing cardiovascular Events (UMPIRE) trial, showed that access to a cardiovascular polypill (aspirin, statin and two blood pressure lowering drugs) significantly improved adherence, lowered systolic blood pressure (SBP) and low-density lipoprotein cholesterol (LDLc) in patients with or at high risk of cardiovascular disease (CVD). We aimed to analyze the within-trial cost-effectiveness of the polypill strategy versus usual care in India. METHODS: Relative effectiveness and costs of polypill versus usual care groups in UMPIRE were estimated from the health sector perspective. Only direct medical costs were considered. The effectiveness of the polypill was reported as a percentage increase in adherence and mean reductions in SBP, and LDL-c, over the 15-month trial period. Healthcare resource utilization and costs were collected for each patient during the trial. Polypill price was constructed using a range of scenarios: $0.06-$0.94/day. The cost-effectiveness of the polypill was measured as the additional cost for 10% increase in adherence, and per unit reduction in SBP and LDL-c. RESULTS: Overall, the mean cost per patient was significantly lower with the polypill strategy (-$203 per person, (95% CI: -286, -119, p < 0.01). In scenario analyses that varied polypill price assumptions, incremental cost-effectiveness ratios for a polypill strategy ranged between cost-saving to $75 per 10% increase in adherence for polypill price of $0.94 per day. CONCLUSIONS: The polypill strategy was cost-saving compared to usual care among patients with or at high risk of CVD in India.

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http://hdl.handle.net/10453/161701