Pharmacy & Therapeutics - November 2008 - (Page 665)

Switching from Fixed-Dose to Free-Combination Antihypertensive Medications continued from page 662 estimate the direct effect of regimen complexity on compliance and persistence in this study. At least one study53 has shown that switching from one statin to another can result in lower compliance and persistence without added complexity in the regimen. However, persistence for patients who switch at 12 months was only 5.9% less than that for non-switchers, a figure that is far less than the 43.4% lower persistence for switchers found in our study. Furthermore, the Thibaud study offered no reasons for the observed differences between switchers and non-switchers. Although propensity-score matching was used to select FDC and FC samples of patients who were similar on observed factors, patients who switched from FDC to FC may differ from patients who stayed with the FDC regimen in characteristics that were unobserved and that may correlate with compliance. For example, if a change in health insurance coverage prompted the switch from FDC to FC therapy, then changes in plan benefit design, such as prescription copayment rates, could also influence the observed rate of prescription refills and, therefore, persistence and compliance. Finally, reasons for a patient’s switch from FDC to FC regimens were not available for further stratification. CONCLUSION Patients who continued with fixed-dose combination (FDC) antihypertensive therapies showed higher rates of compliance and persistence and had lower utilization and expenditures for hypertension-related health care, compared with patients who switched from FDC to free-combination (FC) therapy. Higher compliance and persistence are likely to produce positive health benefits through better control of hypertension and positive economic benefits through lower expenditures for hypertension-related health care. 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Table of Contents Feed for the Digital Edition of Pharmacy & Therapeutics - November 2008

Pharmacy & Therapeutics - November 2008 Contents Editorial Medication Errors Prescription: Washington New Drugs/Drug News/New Medical Devices Drug Forecast Heparin-Induced Thrombocytopenia Medication Utilization Patterns and Hypertension-Related Expenditures among Patients Who Were Switched From Fixed-Dose to Free-Combination Antihypertensive Therapy European Society for Medical Oncology and Association for the Study of Bone and Mineral Research Pharmaceutical Approval Update

Pharmacy & Therapeutics - November 2008

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