New study predicts outcomes of CV patients using polypill intervention

Study Published In BMJ Open Demonstrates that a 20% Improvement In Treatment Adherence With Cardiovascular (CV) Polypill, Prevents Up to 15% More Secondary CV Events

A new study published in the journal BMJ Open (May 2015) has demonstrated that the improved treatment adherence achievable using a fixed-dose combination polypill (atorvastatin, ramipril and low-dose aspirin) to prevent recurring myocardial infarction, can avoid up to 15% more fatal and non-fatal CV events, conferring potential savings to healthcare systems.

• Cardiovascular disease is the number one cause of death worldwide and it is estimated to kill about 23.3 million people per year by 2020.
• New polypill developed by CNIC-Ferrer, uniquely combines atorvastatin, ramipril and low-dose aspirin to provide all-round CV protection against cardiovascular disease for people who have had a previous event.
• Cost effectiveness analysis applied to UK proves that if just 10% of the 450,000 adults at risk of a recurring myocardial infarction switch to the polypill instead of the monocomponents, achieving a 20% improvement in adherence, a further 3,260 events and 590 deaths could be prevented across a decade.
• Study proves that the polypill is a cost-effective strategy for secondary prevention of fatal and non-fatal CV events in the UK.

Many deaths and disabilities due to cardiovascular disease are preventable through lifestyle modification and controlling known risk factors. However with an ageing population in the world predicted to triple by 2050, improved strategies to manage CV risk are important. Furthermore, and in particular, it is known that high treatment adherence significantly improves health outcomes in secondary prevention and avoid health related costs which can result in improved cost-effectiveness for healthcare systems.

The study, which was conducted from a UK perspective, used a Markov model to predict the outcomes of a patient population using the polypill intervention. The patient population was selected to represent a risk profile typical of patients found in the UK and Western European countries - 72% male, mean age of 64.7 years and with a previous diagnosis of myocardial infarction. Model equations were used to determine the rates at which CV events occur as a function of baseline risks and therefore the likely effects of the person taking a polypill for a period of up to ten years. Cost-effectiveness assessments were made using known health economic modelling techniques to demonstrate that the 20% increase in adherence using a polypill intervention could lead to a significant reduction in deaths and non-fatal CV events - 47 per 1,000 patient population - over a 10-year period in the model examined, and a significant reduction in costs to healthcare systems.

The Fuster-CNIC-Ferrer Polypill has been developed by the Spanish pharmaceutical company, Ferrer, in partnership with the Spanish National Centre for Cardiovascular Research (CNIC), to uniquely combine three mono-agents (atorvastatin, ramipril and low-dose aspirin). Taken once-a-day and already approved in more than 22 countries (15 of them in the EU), the polypill reduces dose complexity with the potential to improve overall adherence to treatment as demonstrated in the Markov model and in previous clinical trials.

Dr. Fuster, General Director of CNIC, said: "The study demonstrates how improvements in adherence made possible by using the polypill strategy can achieve significant improvements in treatment outcomes and cost savings to healthcare systems by reducing recurrent CV events."

Fernando García-Alonso, Chief Scientific Officer at Ferrer, commented: "CNIC-Ferrer has pioneered a way to make the polypill suitable using its deep scientific and manufacturing experience."