COST-EFFECTIVENESS OF ROSUVASTATIN/EZETIMIBE THERAPY IN HIGH-RISK HYPERTENSIVE PATIENTS WITH UNCONTROLLED HYPERCHOLESTEROLEMIA BY A PREVIOUS SIMVASTATIN/EZETIMIBE TREATMENT

Objective: Combination therapy may help achieve low-density lipoprotein cholesterol (LDL-C) goals in high-risk patients. In this respect, the role of Rosuvastatin and Ezetimibe (RE) has not been fully characterized in high-risk hypertensive outpatient subjects. The aim of this study was to evaluate the cost-effectiveness of treatment with RE in fixed-dose combination in patients with uncontrolled hyper-cholesterolemia by a Simvastatin and Ezetimibe (SE) therapy and to compare the costs between the two therapies. Design and method: 32 subjects (46.8% men, mean age 67.8 ± 11.1 years) with uncontrolled LDL-C levels (109.4 ± 14.2 mg/dL) and treated with SE (40 mg and ezetimibe 10 mg daily, 56.3% in fixed-dose combination), were switched to once-daily fixed-combination therapy with RE 10/10 mg (n = 18) or 20/10 mg (n = 14). The monthly cost for treating patients with SE and RE was estimated using pharmacy dispensing records. The change of LDL-C level, the tolerability analyses (i.e AST, ALT and CPK values) and the costs of treatment were compared using parametric and non-parametric statistic tests. Results: After a median time of 76 days, RE treatment were associated with significant decrease of LDL-C levels (−25%, Wilcoxon signed-rank test p < 0.001) and costs reduction (−39.4%). The LDL-C target (i.e. < 70 mg/dL) value was reached in 32% of cases. The average cost of RE therapy is also lower than the minimum cost of the SE combination (26.64 vs. 33.76 €, p<0.01). No adverse event was observed during the RE treatment and safety parameters was not-different at the follow-up. Conclusions: RE in fixed-dose combination therapy was safe and cost-effective on improving LDL-C levels than a SE treatment. The adoption of treatment of RE in single-pill combination has a benefit in terms of health care planning, as the cost of therapy becomes much more easily predictable due to the lower variability of a single clinical strategy. However, for definite conclusions, further prospective studies including a wider number of subjects comparing RE and SE treatment in this setting of HTs are needed.