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. 2025 Sep 1;43(9):1478-1484.
doi: 10.1097/HJH.0000000000004050. Epub 2025 Jun 16.

Treating hypertension with single pill combinations: a simple strategy to save costs for the patients and payers

Miriam Pikkemaat  1   2 , Emily R Atkins  3 , Anthony Rodgers  3 , Aletta E Schutte  3   4
Affiliations

Treating hypertension with single pill combinations: a simple strategy to save costs for the patients and payers

Miriam Pikkemaat et al. J Hypertens. .

Abstract

Objectives: Our aim was to compare direct costs for single pill combinations (SPCs) and free-drug combinations for hypertension treatment.

Methods: We focused on Australia as a case study and reviewed total costs, and for the patient and government. We reviewed the Australian "Pharmaceutical Benefits Scheme item drug map" considering different thresholds for the government safety net. Total costs included medicine costs and pharmacy fees.

Results: For patients, SPCs always cost less than free-drug combinations, with greatest savings for general patients before reaching safety net (averaging 30%). For government, SPCs cost on average less than free-drug combinations, for Concession Card holders both before (averaging 11%) and after reaching safety net (averaging 26%) and in general patients after safety net (averaging 11%). There was a slight increase in costs (16%) for the government for patients before reaching safety net. All findings were driven by savings in dispensing fees, the main cost of supply, also after the recent introduction of 60-day dispensing.

Conclusion: Single pill combinations, instead of free-drug combinations, result in cost saving for both patient and government in almost all cases and often these savings are large. SPC cost savings should be factored into prescribing decisions, both for people receiving multiple pills and people starting treatment.

Keywords: blood pressure; cost comparison; cost minimization analysis; drug combinations; fixed-dose combination; single pill combination.

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Conflict of interest statement

George Health Enterprises Pty Ltd, the social enterprise arm of The George Institute for Global Health (TGI), has received investment to develop fixed-dose combination products containing aspirin, statin and blood-pressure lowering drugs. TGI holds and have filed applications for method of treatment and composition patents in relation to low and ultra-low-dose fixed-dose combination products for the treatment of hypertension and diabetes, and Professor Rodgers is listed as one of the inventors (Granted: US 10 369 15; US 10 799 487; US 10 322 117; US 11 033 544; US 11 478 462; Pending: US 17/932 982; US 18/446 268; US 17/598 122; US 17/317 614). Professor Rodgers is seconded part-time to George Medicines Pty Ltd (GM), a subsidiary of George Health Enterprises. All staff employed by TGI have an institutional interest to declare with respect to George Health Enterprises. None of the TGI staff have a direct financial interest in these investments. AES received speaker honoraria and/or travel fees from Servier, Novartis, Medtronic, Omron, Sanofi, AstraZeneca, Abbott, and Aktiia.

Figures

FIGURE 1
FIGURE 1
Absolute price reduction in AUD using single pill combinations (SPCs) instead of free-drug combinations, for the 57 different available SPCs.
FIGURE 2
FIGURE 2
Price reduction in % for supply of 60 days of medicines using single pill combinations (SPCs) instead of the free-drug combinations, for 57 available SPCs.
See this image and copyright information in PMC

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