Potential cost-effectiveness of polypill estimated
The costs of prescribing the “polypill” to all adults over the age of 50 years for the primary prevention of cardiovascular disease could preclude its use, according to researchers (Journal of Epidemiology
and Community Health 2006;60:213).
The proposed polypill — consisting of three blood pressure lowering
drugs, a statin, folic acid and aspirin — was first mooted
in 2003 (PJ, 28 June 2003, p881). Three years later, researchers have calculated
the potential costs of widespread treatment with the pill using data
collected from the Framingham Heart Study and the Framingham Offspring
Study. To be cost-effective among populations at a 20 per cent 10-year
risk of coronary heart disease, the annual cost of the polypill should
be no more than €302 for men aged 50 years and €410 for men aged 60 years,
they say.
“Even if the polypill would be offered for free no cost savings
would be achieved if the intervention were implemented in populations
at moderate
levels of risk or if it would be given to the total population irrespective
of risk levels,” said the researchers.
They conclude that the largest benefits would be obtained if the polypill
were to be given to everyone from aged 60 years or to those over 60 years
with a high risk of CVD. “However, this implies the medicalisation
of a large section of the population and the exposure of healthy subjects
to adverse effects.” |
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