A “polypill” could prevent cardiovascular disease

February 3, 2025

We often focus on how personalization can improve medicine. Pharmacogenomics can predict which antidepressants will be most effective, and genetic tests help oncologists choose the best and safest treatment for cancer. Many of the most promising recently introduced treatments, like CAR-T (chimeric antigen receptor T cell) therapy, involve genetic manipulation of a patient’s own cells.

But an effective, inexpensive treatment that can be used uniformly across a large section of the population is more scalable and could lead to genuine health improvement. Researchers have been evaluating the use of a “polypill” to prevent cardiovascular disease for over 15 years. Such a polypill would include a statin (to lower bad cholesterol), and low doses of blood pressure medicines. Some polypills have also included a medicine to decrease blood clotting. Putting modest doses of these medications together in a single pill could prevent many heart attacks and strokes, while causing a relatively small number of side effects.

Researchers published projections of cost effectiveness of such a polypill this month in JAMA Cardiology, using data from a clinical trial that included a low-income predominantly Hispanic population. They found that this intervention was cost-saving in almost all (99%) of simulations if the pill cost less than $443 a year, a price based on current costs of the component generic medications. There is no polypill on the market in the US. But such a pill could save many lives at very low cost.

Implications for employers:

• Simple interventions that are scalable over a large portion of the population are more likely to be widely adopted.

• Population health can be substantially improved by promoting adherence to existing generic medications available for low costs.

• Patients are more likely to be adherent to a single pill compared to multiple pills.

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Illustration by meta.ai