The World Health Organization (WHO) had proposed the cardiovascular polypill more than a decade ago as a ‘best buy’ intervention for secondary prevention, and a simple, cost-eﬀective strategy to reduce the evidence implementation gap and as an instrument to improve the prescription, accessibility, adherence and cost of secondary CVD prevention.
The concept of a polypill, composed of a combination of medications that are known to effectively treat CVD, has been proposed as a simple, cost effective and innovative public health strategy to combat the CVD epidemic on a global scale. Several studies have shown the polypill to be well tolerated and superior in terms of adherence to standard of care.
Polypills include guideline-recommended treatments for secondary prevention, such as BP-lowering, cholesterol-lowering and antiplatelet drugs. Polypill strategies have been shown to be effective.
Safe and cost-effective in terms of increasing drug adherence and improving risk factor proﬁles. As a result of these ﬁndings, the use of polypills was included in the 2016 European Guidelines on CVD prevention in clinical practice.
A cardiovascular Polypill could be one potential solution to poor compliance by simplifying the treatment regimen.
The POLYCAP is fixed-dose combination of three blood-pressure-lowering drugs, Atenolol 50 mg, Ramipril 5 mg, Hydrochlorothiazide 12.5 mg, along with a lipid lowering drug, Simvastatin 20mg and an anti-platelet agent, Aspirin 100mg.View More Polypill in Guidelines
By avoiding complex algorithms to identify individuals for therapy, increasing the ease of prescribing, and avoiding multiple steps for dose titration of each drug, more at-risk individuals could be treated and blood pressure would be reduced more quickly and substantially.
A study of high-risk patients with ischemic heart disease (IHD) or diabetes mellitus showed that use of a cardioprotective bundle, a simplified regimen involving fixed doses of a generic Statin and ACE inhibitor/ARB, delivered with minimal physician visits, reduced hospitalizations for IHD or stroke within 1 year. Moreover, fixed-dose combination drugs are already widely used in hypertension and in other conditions such as AIDS and tuberculosis.
Individuals would need to take only one instead of several pills per day for CVD prevention, which may enhance adherence.
Costs of a Polypill using generic components are likely to be much lower than the total costs of individual drugs.
Literature Review and New Product Development Work
Protocol for Clinical Trial
Invited Dr Yusuf to head The Indian PolycapTM Study
The Indian PolycapTM Study
PolycapTM in ACC Plenary Session
PolycapTM on the Cover of Lancet
TIPS-3 trial (Results published in the NEJM)
Commercial Launch of PolycapTM