Abstract 3868: Adherence Benefits in Older Patients of a Single Pill Combining Amlodipine and Atorvastatin Compared With Multi-Drug Calcium Channel Blocker and Statin Combinations
Objective: To assess whether older patients (who generally have a higher pill burden and are less adherent than younger patients) who were prescribed a single-pill combination of amlodipine besylate/atorvastatin calcium achieved greater adherence compared with those coadministered amlodipine and atorvastatin, or other calcium channel blockers (CCBs) and other statins separately.
Methods: The CARPE - PBM adherence study included 2098 patients aged ≥ 65 years whose drug benefits were managed by a large U.S. Pharmacy Benefit Management company. Patients were required to be newly initiated on a CCB or statin, within 30 days of each other regardless of initiation sequence. Adherence was measured during a 6-month post baseline period as proportion of days covered (PDC) based on the days that both antihypertensive and lipid-lowering drugs were supplied. Adherence was considered achieved if PDC was ≥ 80%. Propensity-score weighted logistic regression and proportional hazard models were used to adjust for demographic, clinical, and health service variables.
Results: At baseline, mean age was 74 years, 60% were female, 15% took coronary vasodilators, 31% anti-diabetics; the mean number of other baseline medications was 8. The percentages of patients receiving single-pill combination amlodipine/atorvastatin, coadministered amlodipine + atorvastatin, and other CCB + other statin achieving PDC ≥ 80% were 70.1%, 54.3%, and 38.1%, respectively. After adjusting for key covariates and cohort differences, odds ratios (ORs) were 1.24 (CI: 1.09–1.41; P < 0.001) for the probability of achieving adherence in patients receiving single-pill combination amlodipine/atorvastatin versus amlodipine + atorvastatin, and 1.99 (CI:1.75–2.25; P < 0.0001) for single-pill combination amlodipine/atorvastatin versus other CCB + other statin.
Conclusions: In this nationally representative, insured population, older patients receiving single-pill amlodipine/atorvastatin demonstrated a greater likelihood of achieving adherence compared with multi-drug combinations, including the coadministration of its parent compounds. Single-pill amlodipine/atorvastatin may provide a practical solution to managing CV risk in older patients by improving patient adherence.