Combination pill could be cost effective in preventing heart disease

January 16, 2013

(Medical Xpress)—A single combination pill could reduce cardiovascular disease and stroke in Latin Americans by up to 21 percent at a cost of about $35 per quality adjusted life year gained, according to a study led by a University of Wisconsin School of Medicine and Public Health research team.

"Our simulation study showed that a pill that combines aspirin, a drug that lowers blood cholesterol (a statin), and three drugs that , could be one of the most cost-effective to reduce heart attack, stroke and other cardiovascular health risks," says study leader Dr. Leonelo Bautista, associate professor of population health sciences. Bautista led a team that included academics and public health leaders from across South America, Central America and the Caribbean.

They looked at the costs of treating people at high risk of developing cardiovascular disease with a polypill and the benefits of that intervention in terms of gains in quality-adjusted life years (QALY), a measure that takes into account both the quantity and quality of life generated by a health care intervention.

The study found the pill could reduce the of cardiovascular disease by 15 percent in women and 21 percent in men. The results of the study suggest that the pill should be offered to women at high risk of developing cardiovascular disease and to all men 55 years and older. Using the polypill in these groups would result in a cost of about $35 per quality-adjusted life year gained.

The polypill was not only cost-effective for preventing cardiovascular disease and stroke, but was also cost-effective compared with many interventions already in use in Latin America. For instance, the cost of $35 per QALY for the polypill compares to $56 per QALY for annual screening for , $700 per QALY for to check for , or $1,020 per QALY for the use of angiotensin-converting enzyme (ACE) inhibitors for .

The per capita gross national income in the countries included in the study ranged from $4,710 in Peru to $15,500 in Puerto Rico. In all countries the additional cost of gaining one QALY was many times lower than the per capita gross national income, the recommended guideline to identify if an intervention is cost-effective.

"By all measures, this type of intervention would be cost-effective, and could also be cost-saving," says Bautista, who also says that the findings of this type of study can help governments in defining public health policies to prevent cardiovascular diseases.

While such a "polypill" is not available in the United States at this time, there is evidence that using a polypill in US men 55 years old and older could result in lower cost and higher health benefit that the standard approach of screening and treating for hypertension and hypercholesterolemia.

The study is being published in the January edition of the journal Health Affairs. A grant from the Inter-American Development Bank supported the study.

About the Polypill

A "polypill" is a tablet or capsule consisting of a combination of drugs to reduce several cardiovascular risk factors simultaneously: aspirin, a statin (to lower cholesterol), and three drugs to lower blood pressure. All components of the polypill have been shown to reduce cardiovascular disease events by 20 to 35 percent in people with, and without, previous cardiovascular events, but the impact of a is uncertain.

It is known that cardiovascular disease deaths could be cut by half by reducing smoking, blood cholesterol, and blood pressure. Unfortunately, using medication to prevent cardiovascular disease and stroke by treating a minority of patients with high values of blood pressure and blood cholesterol can achieve only modest reductions in the in the population. The idea of a "" is based on using an intervention on everyone at increased risk, regardless of individual level of and blood pressure, and reducing three risk factors with only one pill.

Explore further: International trial finds polypill halves predicted heart disease and stroke risk

More information: content.healthaffairs.org/cont … nt/32/1/155.abstract

Related Stories

International trial finds polypill halves predicted heart disease and stroke risk

May 25, 2011
The world's first international polypill trial has shown that a four-in-one combination pill can halve the predicted risk of heart disease and stroke. The results are published online today in the open access journal PLoS ...

People more likely to take heart medicines in combo pill

November 6, 2012
People are much more likely to take heart medicines if they're combined in one pill, according to a late-breaking clinical trial presented at the American Heart Association's Scientific Sessions 2012.

First Polypill trial in people selected on age alone (50 and over) shows substantial health benefit

July 18, 2012
Results of a randomised trial carried out by academics at Queen Mary, University of London and published today in PLoS One [1] show that a four-component Polypill given to people aged 50 and over to reduce their risk of heart ...

Recommended for you

New molecule may hold the key to triggering the regeneration and repair of damaged heart cells

August 21, 2017
New research has discovered a potential means to trigger damaged heart cells to self-heal. The discovery could lead to groundbreaking forms of treatment for heart diseases. For the first time, researchers have identified ...

Researchers investigate the potential of spider silk protein for engineering artificial heart

August 18, 2017
Ever more people are suffering from cardiac insufficiency, despite significant advances in preventing and minimising damage to the heart. The main cause of reduced cardiac functionality lies in the irreversible loss of cardiac ...

Lasers used to detect risk of heart attack and stroke

August 18, 2017
Patients at risk of heart attacks and strokes may be spotted earlier thanks to a diagnosis tool that uses near-infrared light to identify high-risk arterial plaques, according to research carried out at WMG, University of ...

Cholesterol crystals are sure sign a heart attack may loom

August 17, 2017
A new Michigan State University study on 240 emergency room patients shows just how much of a role a person's cholesterol plays, when in a crystallized state, during a heart attack.

How Gata4 helps mend a broken heart

August 15, 2017
During a heart attack, blood stops flowing into the heart; starved for oxygen, part of the heart muscle dies. The heart muscle does not regenerate; instead it replaces dead tissue with scars made of cells called fibroblasts ...

Injectable tissue patch could help repair damaged organs

August 14, 2017
A team of U of T Engineering researchers is mending broken hearts with an expanding tissue bandage a little smaller than a postage stamp.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.