Can a Polypill ‘TIP’ the Scale to a One-Size-Fits All Approach?

Author(s)
Ebony Isis Evans, PharmD
Katy Pincus, PharmD, BCPS, BCACP

Reviewers:
Sara Wettergreen, PharmD, BCACP
Stuart T Haines, PharmD, BCPS, BCACP

Citation: Yusuf S, Joseph P, Dans A, et al. Polypill with or without Aspirin in Persons without Cardiovascular Disease. N Engl J Med 2021; 384: 216-228.

The Problem

Some have argued (half-heartedly) that statins should be added to the drinking water. Perhaps we should add three anti-hypertensive agents to the water too? Would that lead to dramatic population-wide reductions in cardiovascular events? Could a polypill, a combination product comprised of four medications, ‘tip’ the scales? Creating an ideal therapeutic regimen is often like putting a puzzle together, with adherence being a critical piece of that puzzle. Studies, and clinical experience, show that patients are more likely to adhere to once daily medication administration when compared to regimens that require more frequent dosing.¹ And we know that less than optimal medication taking leads to higher rates of major adverse cardiovascular events.² Given that pill burden and medication cost are an increasing problem, would our patients benefit from a simple, low-cost, one-size-fits-all approach to addressing cardiovascular risk.