Projected Cost Savings With Optimal Medication Adherence in Patients With Cardiovascular Disease Requiring Lipid-Lowering Therapy: A Multinational Economic Evaluation Study

BACKGROUND: Poor adherence to chronic cardiovascular treatments can impede targeted clinical outcomes. This study esti-mates the potential benefits of improving adherence among patients with cardiovascular disease requiring secondary prevention in Mexico, Thailand, and China. METHODS AND RESULTS: We performed Markov model simulation for patients with cardiovascular disease in 3 countries from health care and societal perspectives over a lifetime horizon. Two scenarios were compared: (1) optimal adherence based on a meta-analysis of 51 randomized controlled trials and (2) status quo. The association between adherence and cardiovascular disease outcomes derives from a dose–response meta-analysis of 4 051 338 patients. Outcomes include the accumulated number of cardiovascular events and associated costs in 2022 US dollars, life years, and quality-adjusted life years. Optimal adherence could prevent 42 (95% credible interval [CrI], 29–56) cardiovascular events in Mexico, 34 (95% CrI, 24–50) in Thailand, and 63 (95% CrI, 43–89) in China per 1000 patients over a lifetime. Incremental effectiveness per patient was 0.60 (95% CrI, 0.47–0.74) life-years in Mexico, 0.68 (95% CrI, 0.37–0.94) quality-adjusted life years in Thailand, and 0.93 (95% CrI, 0.44–1.27) quality-adjusted life years in China. Cost savings from societal perspective amounted to $412 (95% CrI, $211– $723), $316 (95% CrI, $187–$541), and $700 (95% CrI, $355–$1144) per patient for Mexico, Thailand, and China, respectively. Findings remained cost saving in deterministic and probabilistic sensitivity analyses. CONCLUSIONS: Achieving optimal adherence in patients with cardiovascular disease requiring lipid-lowering therapy saves costs and improves health outcomes in Mexico, Thailand, and China. These findings support national health care systems implementing strategies to improve adherence in these countries.