Abstract
The primary prevention of cardiovascular disease is a public health priority. To assess the costs and benefits of a Polypill Prevention Programme using a daily 4-component polypill from age 50 in the UK, we determined the life years gained without a first myocardial infarction (MI) or stroke, together with the total service cost (or saving) and the net cost (or saving) per year of life gained without a first MI or stroke. This was estimated on the basis of a 50 % uptake and a previously published 83 % treatment adherence. The total years of life gained without a first MI or stroke in a mature programme is 990,000 each year in the UK. If the cost of the Polypill Prevention Programme were £1 per person per day, the total cost would be £4.76 bn and, given the savings (at 2014 prices) of £2.65 bn arising from the disease prevented, there would be a net cost of £2.11 bn representing a net cost per year of life gained without a first MI or stroke of £2120. The results are robust to sensitivity analyses. A national Polypill Prevention Programme would have a substantial effect in preventing MIs and strokes and be cost-effective.
Highlights
Cardiovascular disease, myocardial infarction (MI) and stroke, is one of the leading causes of death and disability throughout the world
To assess the costs and benefits of a Polypill Prevention Programme using a daily 4-component polypill from age 50 in the United Kingdom (UK), we determined the life years gained without a first myocardial infarction (MI) or stroke, together with the total service cost and the net cost per year of life gained without a first MI or stroke
Our analysis shows that a Polypill Prevention Programme in which people aged 50 and over are offered a daily polypill would be effective in the prevention of MI and stroke
Summary
Cardiovascular disease, myocardial infarction (MI) and stroke, is one of the leading causes of death and disability throughout the world. This is so even in countries such as the USA and United Kingdom (UK) where age specific mortality rates from MI and stroke have declined [1, 2]. In addition it is generally accepted that people at sufficiently high risk of an MI or stroke should be identified so that they can receive preventive medication This medication could be in the form of a combination pill (polypill) consisting of a statin to lower LDL cholesterol, and low dose blood pressure lowering drugs to reduce blood pressure [3,4,5,6]. On the basis of epidemiological evidence and from randomised trials, that reducing these risk factors has a substantial impact in reducing the risk of MIs and strokes [6, 7]
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