title: Reducing costs and improving hypertension management.
abstract: OBJECTIVE
  To quantify the cost-savings that could be realized by switching patients from two separate agents, ACE inhibitor/ARB and thiazide diuretic, to a fixed dose combination product.
  
  
  METHODS
  CompuScript and Longitudinal Rx (LRx) Insights data from IMS Health Canada for Oct 2006-Sept 2007 was used. From the LRx data, the proportion of patients taking both ACE inhibitors/ARBs and thiazide diuretics as two separate products was calculated to determine how many would qualify for a combination product. From the CompuScript data, the total number of prescriptions for ACE inhibitors and ARBs and the actual average dollar value per prescription for thiazide diuretics, ACE inhibitors, ARBs, and ACE inhibitor/ARB with thiazide diuretic combination products was used to determine the potential cost savings of switching from two separate drugs to a combination product. As a sensitivity analysis, the proportion of patients receiving two separate products who could be switched to a combination product was varied from 60-100%. This analysis was done for Alberta and Canada.
  
  
  RESULTS
  The conversion of ACE inhibitor/ARB and thiazide diuretic as two separate agents to a combination product could potentially result in a yearly cost-savings of $27 to $45 million for Canada ($1.1 to $1.9 million for Alberta), based on 60-100% conversion to a combination product.
  
  
  CONCLUSIONS
  The present analysis has shown that a simple intervention of converting patients receiving separate ACE inhibitor/ARB and thiazide diuretic prescriptions to a single combination product prescription will produce substantial cost-savings for the health care system and simplify the medication regimen for patients.
authors.affiliation: EPICORE Centre, Department of Medicine, University of Alberta, Canada.
authors.forename: Vida
authors.initials: V
authors.lastname: Stankus
authors.forename: Brenda
authors.initials: B
authors.lastname: Hemmelgarn
authors.forename: Norm R C
authors.initials: NR
authors.lastname: Campbell
authors.forename: Guanmin
authors.initials: G
authors.lastname: Chen
authors.forename: Finlay A
authors.initials: FA
authors.lastname: McAlister
authors.forename: Ross T
authors.initials: RT
authors.lastname: Tsuyuki
mesh_terms: D047228:Angiotensin II Type 1 Receptor Blockers / Q000191:economics / Q000627:therapeutic use; D000806:Angiotensin-Converting Enzyme Inhibitors / Q000191:economics / Q000627:therapeutic use; D000959:Antihypertensive Agents / Q000191:economics* / Q000627:therapeutic use*; D002170:Canada; D017046:Cost Savings; D016208:Databases, Factual; D004338:Drug Combinations; D004359:Drug Therapy, Combination; D006801:Humans; D006973:Hypertension / Q000188:drug therapy* / Q000191:economics*; D010349:Patient Compliance; D010818:Practice Patterns, Physicians'; D049993:Sodium Chloride Symporter Inhibitors / Q000191:economics / Q000627:therapeutic use
chemical_list: D047228:Angiotensin II Type 1 Receptor Blockers; D000806:Angiotensin-Converting Enzyme Inhibitors; D000959:Antihypertensive Agents; D004338:Drug Combinations; D049993:Sodium Chloride Symporter Inhibitors