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Rev Esp Cardiol (Engl Ed). 2017 Jan;70(1):42-49. doi: 10.1016/j.rec.2016.05.009. Epub 2016 Jul 26.

Usefulness of a Cardiovascular Polypill in the Treatment of Secondary Prevention Patients in Spain: A Cost-effectiveness Study.

[Article in English, Spanish]

Author information

1
Departamento de Cardiología Adultos, Hospital Universitario Ramón y Cajal, Madrid, Spain. Electronic address: vivenciobarrios@gmail.com.
2
Departamento Científico, Ferrer, Barcelona, Spain.
3
Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain; Icahn School of Medicine Mount Sinai, New York, United States; Servicio de Cardiología, HM Hospitales, Hospital Universitario HM Montepríncipe, Boadilla del Monte, Madrid, Spain.
4
Servicio de Cardiología, Hospital Arnau de Vilanova, Valencia, Spain.
5
Fundación Centro Nacional de Investigaciones Cardiovasculares Carlos III, Madrid, Spain; Icahn School of Medicine Mount Sinai, New York, United States.

Abstract

INTRODUCTION AND OBJECTIVES:

To estimate the health benefits and cost-effectiveness of a polypill intervention (aspirin 100 mg, atorvastatin 20 mg, ramipril 10 mg) compared with multiple monotherapy for secondary prevention of cardiovascular events in adults with a history of myocardial infarction from the perspective of the Spanish National Health System.

METHODS:

An adapted version of a recently published Markov model developed and validated in Microsoft Excel was used to compare the cost-effectiveness of the polypill with that of its combined monocomponents over a 10-year time horizon. The population included in the model had a mean age of 64.7 years; most were male and had a history of myocardial infarction. The input parameters were obtained from a systematic literature review examining efficacy, adherence, utilities, and costs. The results of the model are expressed in events avoided, incremental costs, incremental life years, incremental quality-adjusted life years, and the incremental cost-effectiveness ratio.

RESULTS:

Over a 10-year period, use of the cardiovascular polypill instead of its monocomponents simultaneously would avoid 46 nonfatal and 11 fatal cardiovascular events per 1000 patients treated. The polypill would also be a more effective and cheaper strategy. Probabilistic analysis of the base case found a 90.9% probability that the polypill would be a cost-effective strategy compared with multiple monotherapy at a willingness-to-pay of 30 000 euros per quality-adjusted life year.

CONCLUSIONS:

The polypill would be a cost-effective strategy for the Spanish National Health System with potential clinical benefits.

KEYWORDS:

Adherence; Adherencia; Cost-effectiveness; Coste-efectividad; Policomprimido; Polypill; Prevención secundaria cardiovascular; Secondary cardiovascular prevention

PMID:
27474481
DOI:
10.1016/j.rec.2016.05.009
[Indexed for MEDLINE]

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