Abstract

We would like to make three main points in reply. First, the debate has been framed as ‘tailoring’ versus ‘no tailoring’, which is perhaps not surprising given that polypills are fixed ‑dose combination medi ‑cations. However, tailoring is possible in several ways while still allowing patients to benefit from the adherence improvements of polypills. Numerous types of polypill with different components will become available, many with variable doses of the individual component drugs. Additionally, tailoring can occur ‘on top’ of a polypill.Second, the postulated variations in treat ‑ment effect by pharmacogenetic risk score are extreme, ranging from a large treatment benefit in patients with a risk score <1 to probable harm in patients with a risk score ≥3.

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