Clinical outcomes and healthcare costs in hypertensive patients treated with a fixed-dose combination of amlodipine/valsartan

J Clin Hypertens (Greenwich). 2015 Jan;17(1):51-8. doi: 10.1111/jch.12449. Epub 2014 Dec 5.

Abstract

This retrospective claims database analysis compared two strategies of hypertension treatment in outpatient, emergency, and inpatient departments: a fixed-dose combination (FDC) of amlodipine/valsartan vs free combinations of angiotensin receptor blockers (ARBs) and calcium channel blockers (CCBs) (ARB+CCB group). After a mean follow-up of 15.2 months, the FDC group had significantly lower total healthcare costs (US $1844 vs US $2158; P<.001) and hospitalization rates (14.57% vs 18.43%; P<.001), a higher proportion of days covered (80.35% vs 72.57%; P<.001), and better persistence (266 vs 225 days; P<.001) compared with the ARB+CCB group. The FDC group also had a better major adverse cardiovascular event (MACE)-free survival (hazard ratio, 0.83; 95% confidence interval, 0.73-0.94; P=.003) and decreased rates of heart failure (2.12% vs 3.26%; P<.001), malignant dysrhythmia (0.18% vs 0.42%; P=.021), and percutaneous coronary intervention (0.76% vs 1.26%; P=.015). Compared with free combinations of ARB+CCB, an FDC of amlodipine/valsartan improved MACE-free survival and medication compliance and decreased total healthcare costs and hospitalization rates in hypertensive patients.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Amlodipine / economics*
  • Amlodipine / therapeutic use*
  • Amlodipine, Valsartan Drug Combination
  • Angiotensin Receptor Antagonists / economics
  • Angiotensin Receptor Antagonists / therapeutic use
  • Antihypertensive Agents / economics*
  • Antihypertensive Agents / therapeutic use*
  • Calcium Channel Blockers / economics
  • Calcium Channel Blockers / therapeutic use
  • Cardiovascular Diseases / epidemiology
  • Cohort Studies
  • Dose-Response Relationship, Drug
  • Drug Combinations
  • Drug Therapy, Combination
  • Female
  • Follow-Up Studies
  • Health Care Costs / statistics & numerical data*
  • Hospitalization / economics
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / economics*
  • Hypertension / mortality
  • Incidence
  • Kaplan-Meier Estimate
  • Male
  • Middle Aged
  • Multivariate Analysis
  • Retrospective Studies
  • Tetrazoles / economics*
  • Tetrazoles / therapeutic use*
  • Treatment Outcome

Substances

  • Amlodipine, Valsartan Drug Combination
  • Angiotensin Receptor Antagonists
  • Antihypertensive Agents
  • Calcium Channel Blockers
  • Drug Combinations
  • Tetrazoles
  • Amlodipine