RESULTS: Anonymized medical claims data covering 2012-2018, including patients with hypertension, dyslipidemia, and CV diseases who started a drug therapy either as SPC or identical MPC were analyzed after 1:1-Propensity Score Matching (PSM). 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 ischemic 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 favor of SPC. Mean total costs were 4,708 € for SPC vs. 5.669 € for MPC, respectively (MR 0.830, p<0.001).
CONCLUSIONS: 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.
结果:涵盖2012-2018年的匿名医疗索赔数据,包括高血压患者,血脂异常,在1:1-倾向评分匹配(PSM)后分析以SPC或相同MPC开始药物治疗的CV疾病。具有预定义CV事件的住院,全因死亡率,使用发生率比(IRRs)和连续变量的非参数检验,对25,311例SPC患者和25,311例MPC患者进行了成本研究。SPC的IRR显著较低:卒中(IRR=0.77;95%CI0.67-0.88;p<0.001),短暂性脑缺血发作(IRR=0.61;95%CI0.48-0.78;p<0.001),心肌梗死(IRR=0.76;95%CI0.63-0.90;p=0.0016),冠状动脉疾病(IRR=0.66;95%CI0.57-0.77;p<0.001),心力衰竭(IRR=0.59;95%CI0.54-0.64;p<0.001),急性肾功能衰竭(IRR=0.54;95%CI0.56-0.64;p<0.001),全因住院(IRR=0.72;95%CI0.71-0.74;p<0.001),CV住院(IRR=0.63;95%CI0.57-0.69;p<0.001),和全因死亡率(IRR=0.62;95%CI0.57-0.68;p<0.001)。第一次事件的平均时间和死亡时间也有利于SPC。SPC的平均总成本为4,708€,而不是MPC为5.669€,分别为(MR0.830,p<0.001)。
结论:SPC与较低的CV事件发生率相关,CV事件的时间,和全因死亡,并且在药物经济学参数方面更优越,因此应成为改善结果和降低医疗保健成本的护理标准。