The Scottish Medicines Consortium (SMC) has accepted for use within NHS Scotland, Sevikar HCT® (olmesartan medoxomil, amlodipine besilate and hydrochlorothiazide) as substitution therapy in adult patients whose blood pressure is adequately controlled on the combination of olmesartan medoxomil, amlodipine, and hydrochlorothiazide taken as a dual component (olmesartan medoxomil and amlodipine or olmesartan medoxomil and hydrochlorothiazide) and a single formulation (hydrochlorothiazide or amlodipine). The SMC notes the following:

• In a phase III randomised four-arm study of patients with moderate to severe hypertension, Sevikar HCT was superior to three dual combination therapies for the primary endpoint, change in diastolic pressure.

• In patients for whom concomitant use of these medicines is appropriate it allows administration of a single tablet at a lower or modestly increased cost (depending on dose) compared to another dual combination product plus single component.

• Angiotensin receptor blockers are an alternative to ACE inhibitors where these are not tolerated.

• These fixed dose combinations are among many options for the treatment of hypertension, many of which are less expensive.