Budget Impact Analysis Of Hypertensive Treatment With Indapamide And Amlodipine Single-Pill Combination In The Polish Setting.

Abstract

The aim of this study was to calculate and compare public payer and patients’ costs of hypertensive treatment with indapamide 1.5 mg and amlodipine 5 mg or 10 mg single-pill combination (SPC) and free combination (FC), in the Polish setting. The analysis compared two scenarios: existing and new. The existing one assumed treatment with FC of indapamide 1.5 mg and amlodipine 5 mg or 10 mg. The new one also included treatment with SPC of indapamide 1.5 mg +amlodipine 5/10 mg. Population and market shares were estimated on the basis of published reimbursement data, experts’ opinion and validated with available epidemiological data. Cost data were analysed from the public payer perspective (National Health Fund) and from patient perspective, in a three-year horizon. SPC cost is based on average pharmacy price reported in April 2014 (18.13PLN and 19.75PLN respectively for 1.5+5mg and 1.5+10mg /30 tabs); 30% patient copayment was assumed. The cost of FC was calculated as an average cost of reimbursed indapamide and amlodipine products in corresponding doses. All costs present 2014 values, and are expressed in Polish zloty (PLN). Average monthly exchange rate of May 2014 was applied (1EUR=4.1790PLN). Difference in clinical effectiveness between SPC and FC was also included, in the form of cardiovascular events risk. Introduction of indapamide/amlodipine SPC on the reimbursement list next to FC brought savings from public payer perspective and from patient perspective amounting to: 509,255PLN (121,860EUR) and 5,893,941PLN (1,410,371EUR) in first year, 689,239PLN (164,929EUR) and 7,833,005PLN (1,874,373EUR) in second year, 725,965PLN (173,717EUR) and 8,328,480PLN (1,992,936EUR) in third year. Additionally it resulted in avoidance of 808 cardiovascular events in the three-year horizon. Treatment with indapamide/amlodipine SPC in comparison to FC generates significant savings both from the public payer perspective and from patient perspective in contemporary Polish setting, and reduces cardiovascular events.