Adherence to free and single-pill combination of rosuvastatin/ezetimibe: findings from a real-world analysis in italy

Abstract

Abstract Funding Acknowledgements Type of funding sources: Private company. Main funding source(s): Servier. Background/Introduction Several studies have shown that simplifying cardiovascular drug treatment by alleviating pill burden leads to better treatment adherence. Purpose This real-world analysis aimed to evaluate characteristics and change in adherence in patients treated with rosuvastatin and ezetimibe (ROS/EZE) as free combination who switched to ROS/EZE as single-pill combination, in Italy. Methods A retrospective analysis was performed using administrative databases covering approximately 7 million health-assisted Italian subjects. Adults prescribed with ROS/EZE as a single-pill from January 2010 up to June 2021, were selected. The index date corresponded to the first prescription date of ROS/EZE as single-pill combination; all patients with at least 1 year of data availability before and after the index date were selected. Among selected patients, users of ROS/EZE as a free combination during 1 year before the index date were included in this analysis (patients switching from free to single-pill combination). Baseline demographic and clinical characteristics of these patients were evaluated during the year before index date. Adherence to free or single-pill combination was evaluated as the proportion of days covered (PDC), during 12 months before and after index date (PDC<25% non-adherence; PDC=25-75% partial adherence; PDC>75% adherence). Results A total of 1,219 patients (61.1% male, mean age 66.2 ±10.4 years) met the inclusion criteria. Among them, 83.3% had cardiovascular (CV)-related comorbidities, 26.4% of patients had diabetes mellitus and 16.2% of patients presented a combination of CV disease and diabetes mellitus. A significantly higher percentage of patients were adherent to single-pill compared to free combination (75.2% vs 51.8%, p<0.001). Moreover, the proportion of partially adherent patients (16.4% vs 37.4%, p<0.001) and non-adherent patients (8.4% and 10.7%, p<0.05) was significantly lower with the single-pill combination compared to free combination. Conclusions This analysis provides real-world evidence on adherence of patients to ROS/EZE in free or in single-pill combination, suggesting that switching from multiple to single-pill combination could positively impact the level of adherence to lipid-lowering medications.