A 'polypill' aimed at preventing cardiovascular disease could prove highly cost-effective for use in Latin America

Health Aff (Millwood). 2013 Jan;32(1):155-64. doi: 10.1377/hlthaff.2011.0948.

Abstract

We evaluated the cost-effectiveness of administering a daily "polypill" consisting of three antihypertensive drugs, a statin, and aspirin to prevent cardiovascular disease among high-risk patients in Latin America. We found that the lifetime risk of cardiovascular disease could be reduced by 15 percent in women and by 21 percent in men if the polypill were used by people with a risk of cardiovascular disease equal to or greater than 15 percent over ten years. Attaining this goal would require treating 26 percent of the population at a cost of $34-$36 per quality-adjusted life-year. Offering the polypill to women at high risk and to men age fifty-five or older would be the best approach and would yield acceptable incremental cost-effectiveness ratios. The polypill would be very cost-effective even in the country with the lowest gross national income in our study. However, policy makers must weigh the value of intervention with the polypill against other interventions, as well as their country's willingness and ability to pay for the intervention.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Antihypertensive Agents / administration & dosage*
  • Antihypertensive Agents / economics*
  • Aspirin / administration & dosage*
  • Aspirin / economics*
  • Atenolol / administration & dosage
  • Atenolol / economics
  • Cardiovascular Diseases / economics
  • Cardiovascular Diseases / prevention & control*
  • Cohort Studies
  • Cost-Benefit Analysis
  • Developing Countries*
  • Drug Combinations
  • Female
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / administration & dosage*
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / economics*
  • Latin America
  • Male
  • Markov Chains
  • Middle Aged
  • Quality-Adjusted Life Years
  • Ramipril / administration & dosage
  • Ramipril / economics
  • Randomized Controlled Trials as Topic
  • Risk Factors
  • Simvastatin / administration & dosage*
  • Simvastatin / economics*
  • Sodium Chloride Symporter Inhibitors / administration & dosage
  • Sodium Chloride Symporter Inhibitors / economics

Substances

  • Antihypertensive Agents
  • Drug Combinations
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Sodium Chloride Symporter Inhibitors
  • Atenolol
  • Simvastatin
  • Ramipril
  • Aspirin