A saving of around 105 million euros per year for the National Health Service. According to a study conducted by the Save Research Center (Economic Evaluation Analysis Studies) together with the University of Pavia, promoted by Sandoz, this is the possible result if among patients with primary hypercholesterolemia it was more common the use of fixed dose therapy: a single tablet that combines two active ingredients against high cholesterol, for example atorvastatin and ezetimibe. A treatment that, in addition to increasing therapeutic adherence, reducing cardiovascular events and improving the quality of life of those who take it, would therefore also produce advantages for the NHS funds.
Dyslipidemias – underlines in a note Sandoz, division of the Swiss Novartis dedicated to equivalent and biosimilar drugs – constitute an important risk factor for the development of coronary heart disease; a risk that is controlled with elective therapies such as oral lipid-lowering drugs, including statins, which may be associated with ezetimibe. Often, however, patients also have other diseases and are forced to take many different drugs every day. However, high cholesterol is not perceived as a serious risk factor for cardiovascular health as it does not cause immediate symptoms. This is why therapy against hypercholesterolemia is often considered less essential than others. Result: only 42% of patients who take lipid-lowering drugs do so in the correct dose. In this context, numerous researches show that simplifying therapy improves adherence and, consequently, decreases the number of cardiovascular events such as heart attack, stroke or sudden cardiac death. Now the study coordinated by Giacomo M. Bruno, of the Department of Pharmaceutical Sciences of the University of Paviapublished in ‘Clinico Economics’, also gives an economic value to the phenomenon.
“Starting from the estimate of the patient population that could make use of the fixed dose combination – explains Bruno – we considered the costs related to cardiovascular events with or without complications, compared to the level of adherence to the therapies. Complications, in fact, are often very burdensome for the health system because these patients have to resort to intensive care or surgery. According to our calculations, the adoption of a single tablet leads to a reduction in events due to greater adherence and therefore to annual savings of between 248 and 304 euros per patient. The pharmacoeconomic evaluation obviously also considered the impact of the cost of the drug, in this case very low. Unlike most of the studies that aim to evaluate the economic value of a therapy, the active ingredients we are talking about, atorvastatin and ezetimibe, are off-patent and therefore the impact of the cost of the drug is practically nil “.
In Italy – recalls the note – cardiovascular diseases are the leading cause of death, with about 220 thousand deaths a year: over 62 thousand are caused by ischemic heart diseases, almost 54 thousand by other heart diseases and over 55 thousand by cerebrovascular diseases. High cholesterol, especially LDL levels (the so-called ‘bad’ cholesterol), is considered an important risk factor for the development of heart attack, stroke or sudden cardiac death. Depending on the greater probability of death linked to the presence of different risk factors, the guidelines of the European Society of Cardiology provide for lowering Ldl cholesterol below 70mg / dl if the risk is considered highand below 55mg / dl if very high.
“The fixed associations bring together two drugs that act differently on cholesterol levels: statins inhibit its production, ezetimibe instead acts on absorption – highlights Furio Colivicchi, Uoc Cardiology director of the San Filippo Neri hospital in Rome and president of the National Association of Hospital Cardiologists (Anmco) – Their action is synergistic, which means that the effectiveness is greater than the sum of the two actions. Indeed, patients being treated with these drugs have a 50-60% lowering of LDL cholesterol. By using a single tablet we have an advantage for the patient and we favor the correspondence between his behavior and the doctor’s prescription, thus improving his health conditions and lowering the risk of cardiovascular events “.
A ‘win-win’ situation – the experts remark – where the benefit for the patient also corresponds to a benefit in real time for the national health system. “Promote access to therapies for all those who need them in compliance with quality and efficacy standards. This is the goal of Sandoz, which supports Italian patients with sustainable solutions that improve adherence and effectiveness. of care – declares Paolo Fedeli, Medical Director of Sandoz Italia – We are proud to continue to propose treatment options that improve people’s lives, responding to their still unmet needs and at the same time contributing to the sustainability of the health system “.