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Vida Stankus
Brenda Hemmelgarn
Norm RC Campbell
Guanmin Chen
Finlay A McAlister
Ross T Tsuyuki


Hypertension, combination products, cost-savings, adherence



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.


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.


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.


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.

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