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An economic case for a cardiovascular polypill? A cost analysis of the Kanyini GAP trial

Laba, Tracey-Lea, Hayes, Alison, Lo, Serigne, Peiris, David, Usherwood, Tim, Hillis, Graham, Rafter, Natasha, Reid, Christopher, Tonkin, Andrew, Webster, Ruth, Neal, Bruce, Cass, Alan, Patel, Anushka, Rodgers, Anthony and Jan, Stephen (2014). An economic case for a cardiovascular polypill? A cost analysis of the Kanyini GAP trial. Medical Journal of Australia,201(11):671-673.

Document type: Journal Article
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IRMA ID 11381xPUB21
NHMRC Grant No. 1004623
57132
Title An economic case for a cardiovascular polypill? A cost analysis of the Kanyini GAP trial
Author Laba, Tracey-Lea
Hayes, Alison
Lo, Serigne
Peiris, David
Usherwood, Tim
Hillis, Graham
Rafter, Natasha
Reid, Christopher
Tonkin, Andrew
Webster, Ruth
Neal, Bruce
Cass, Alan
Patel, Anushka
Rodgers, Anthony
Jan, Stephen
Journal Name Medical Journal of Australia
Publication Date 2014
Volume Number 201
Issue Number 11
ISSN 0025-729X   (check CDU catalogue open catalogue search in new window)
Start Page 671
End Page 673
Total Pages 3
Place of Publication Australia
Publisher Australasian Medical Publishing Company Pty. Ltd.
HERDC Category C1 - Journal Article (DIISR)
Abstract Objective: To measure the costs of a polypill strategy and compare them with those of usual care in people with established cardiovascular disease (CVD) or at similarly high cardiovascular risk.

Design: A within-trial cost analysis of polypill-based care versus usual care with separate medications, using data from the Kanyini Guidelines Adherence with the Polypill (GAP) trial and linked health service and medication administrative claims data.

Participants:
Kanyini GAP participants who consented to Australian Medicare record access.

Main outcome measures: Mean health service and pharmaceutical expenditure per patient per year, estimated with generalised linear models. Costs during the trial (randomisation January 2010 – May 2012, median follow-up 19 months, maximum follow-up 36 months) were inflated to 2012 costs.

Results: Our analysis showed a statistically significantly lower mean pharmaceutical expenditure of $989 (95% CI, $648–$1331) per patient per year in the polypill arm compared with usual care (P < 0.001; adjusted, excluding polypill cost). No significant difference was shown in health service expenditure.

Conclusions: This study provides evidence of significant cost savings to the taxpayer and Australian Government through the introduction of a CVD polypill strategy. The savings will be less now than during the trial due to subsequent reductions in the costs of usual care. Nonetheless, given the prevalence of CVD in Australia, the introduction of this polypill could increase considerably the efficiency of health care expenditure in Australia.


DOI http://dx.doi.org/doi:10.5694/mja14.00266   (check subscription with CDU E-Gateway service for CDU Staff and Students  check subscription with CDU E-Gateway in new window)


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