Efficiency of fixed-dose combinations of statin and ezetimibe in the treatment of hypercholesterolemia

Objective To estimate the clinical and economic benefits derived from increasing the use of fixed-dose combinations of high-intensity statins and ezetimibe in patients at high/very high cardiovascular risk, from the perspective of the Spanish National Health System (SNS). Methods A baseline scenario (current market shares) was compared with scenarios that increased the use of fixed-dose combinations (alternative: 30% increase; optimized: 69% increase). The potential annual increase in the number of controlled patients, cardiovascular events avoided and the associated savings in direct medical costs were estimated, including the cost of pharmacological treatment, follow-up, and managing cardiovascular events over a three-year time horizon. Results Over the three years of the study, the baseline scenario estimated a total of 1,552,686 controlled patients and 39,449 cardiovascular events, with a total cost to the NHS of €1,841,057,122. In the alternative scenario, controlled patients would increase by 36.1%, and 139 cardiovascular events would be avoided, resulting in savings for the NHS of 36,116,631 €. In the optimized scenario, there would be a 64% increase in controlled patients and 250 CV events would be avoided, leading to savings of 56,415,300 € for the NHS. Conclusion Increased use of high-intensity statin and ezetimibe fixed-dose combinations in patients with high/very high CV risk may increase the number of controlled patients, reduce CV events and produce economic savings from an NHS perspective.