Abstract：
OBJECTIVE: Our study aimed to assess whether a single pill concept (SPC) is superior to a multi pill concept (MPC) in reducing cardiovascular (CV) events, all-cause death, and costs in CV patients.
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.
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.
摘要：
目的：我们的研究旨在评估单药丸概念（SPC）在减少心血管（CV）事件方面是否优于多药丸概念（MPC）。全因死亡,和CV患者的费用。
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。
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。
