Copayment level, treatment persistence, and healthcare utilization in hypertension patients treated with single-pill combination therapy

AbstractObjectives:To evaluate the relationship between drug copayment level and persistence and the implications of non-persistence on healthcare utilization and costs among adult hypertension patients receiving single-pill combination (SPC) therapy.Methods:Patients initiated on SPC with angiotensin receptor blocker (ARB) + calcium channel blocker, ARB + hydrochlorothiazide, or angiotensin-converting enzyme inhibitors + hydrochlorothiazide were identified in the MarketScan Database (2006–2008). Multivariate models were used to assess copayment level as a predictor of 3-month and 6-month persistence. Three levels of copayment were considered (low: ≤$5, medium: $5–30, high: >$30 for $60 for ≥90-day supply). Separate models examined the implications of persistence during the first 3 months on outcomes during the subsequent 3-month period, including utilization and changes in healthcare costs from baseline. National- and state-level outcomes were analyzed.Res...