Fixed-dose drug combo most cost effective treatment for hypertension, study finds

When a patient requires a medication adjustment to better manage high blood pressure, switching to a fixed-dose combination therapy is the most cost effective option, according to a study published in the Journal of Managed Care & Specialty Pharmacy.

For the study, researchers accessed the Blue Cross Blue Shield of Texas claims database to track annual drug costs — along with hypertension-related outpatient and inpatient healthcare costs — for 6,000 patients who had their blood pressure medication modified within one year of starting the regimen between 2008 and 2012.

Patients who switched to a fixed-dose combination therapy represented the most expensive treatment option upfront, costing the an average of $310 per patient, followed by switching to a new drug ($135), gradually increasing the dose of the current medication ($63) and gradually decreasing the current drug's dose ($61).

When researchers accounted for follow-up healthcare costs, patients taking a fixed-dose combination therapy cost the health plan the least at an average of $1,731. Patients who decreased the dose of their current drug cost the insurer an average of $2,985. Individuals who switched to a new drug or increased the dose of the current drug cost the health plan $7,076 and $7,692, respectively.

"Even though the drug costs for fixed-dose combination appear to be extremely high, it is offset by savings in health services costs, saving almost seven times the cost in inpatient visits," lead author Kalyani Sonawane, PhD, told Science Daily.

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