title: Persistence with a single pill versus two pills of amlodipine and atorvastatin: the Australian experience, 2006-2010.
abstract: OBJECTIVE
  To study patient persistence on therapy for hypertension and dyslipidaemia using a single-pill combination compared with a two-pill approach.
  
  
  METHODS
  Post-hoc observational assessment of Pharmaceutical Benefits Scheme claim records covering the period April 2005 to March 2010.
  
  
  METHODS
  A 10% random sample of Australian long-term concession card holders was analysed. The patients studied had commenced on either amlodipine and atorvastatin as two individual pills, or a single pill containing both amlodipine and atorvastatin (AA), with neither combined approach having been dispensed to them in the previous 6 months.
  
  
  METHODS
  The proportions of patients failing to fill their first repeat prescription after 1 month or failing to persist with treatment at 12 months, and the median persistence time (MPT) were measured.
  
  
  RESULTS
  Of 4146 patients prescribed the AA single pill, 11% failed to fill the first repeat prescription and 33% had ceased treatment by 12 months (MPT, 35 months). Of 6204 patients prescribed amlodipine and atorvastatin as two pills, 23% failed to fill the first repeat prescriptions and 59% had ceased treatment by 12 months (MPT, 7 months). In a multivariate model, cessation of single-pill therapy increased by 165% if there was no prior therapy, but only increased by 48%-55% if there was no prior therapy with a calcium channel blocker or statin. MPT on the single pill was 8 months in those without prior antihypertensive therapy, but was ≥ 37 months in those with any prior antihypertensive therapy.
  
  
  CONCLUSIONS
  A single-pill combination drug is associated with superior long-term persistence compared with two-pill therapy in the management of hypertension and dyslipidaemia.
authors.affiliation: St Vincent's Hospital, University of New South Wales, Sydney, NSW, Australia. l.simons@unsw.edu.au
authors.forename: Leon A
authors.initials: LA
authors.lastname: Simons
authors.forename: Michael
authors.initials: M
authors.lastname: Ortiz
authors.forename: Gordon
authors.initials: G
authors.lastname: Calcino
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D017311:Amlodipine / Q000008:administration & dosage*; D000924:Anticholesteremic Agents / Q000008:administration & dosage*; D000959:Antihypertensive Agents / Q000008:administration & dosage*; D001315:Australia; D016208:Databases, Factual; D004338:Drug Combinations; D006538:Heptanoic Acids / Q000008:administration & dosage*; D006801:Humans; D008875:Middle Aged; D015999:Multivariate Analysis; D011758:Pyrroles / Q000008:administration & dosage*; D016903:Drug Monitoring
chemical_list: D000924:Anticholesteremic Agents; D000959:Antihypertensive Agents; D004338:Drug Combinations; D006538:Heptanoic Acids; D011758:Pyrroles; C487936:amlodipine, atorvastatin drug combination; D017311:Amlodipine