Many of the 3.5 million Australians with cardiovascular disease, or otherwise at high risk of future heart attack or stroke, do not receive the full benefits of proven medicine regimens. In part this is due to the challenges, cost, complexity and stigma of taking multiple medications long-term. Since about 60% of cardiovascular deaths in the community occur in these patients, effective strategies that reduce this treatment ‘gap’ could have a major impact. Yet new effective strategies in this area are lacking.
Reducing cost and complexity
The George Institute is conducting one of the world’s first randomised controlled trials of a polypill, containing four drugs in one pill, for preventing cardiovascular disease. Combining these drugs has two major potential benefits:
-
Reducing cost – With only one pill to buy, the ongoing financial burden of treatment may be greatly reduced. The polypill also uses reliable, proven generic drugs to reduce the cost of manufacture and therefore further reduce the purchase price and prescription costs. At a patient and national level, this could translate to major cost savings.
-
Reducing complexity – For patients, the simplicity of taking just one pill may make this treatment simple to take. For practitioners, there may be reduced complexity in drug selection. The availability of all indicated drugs for this patient population in a single polypill may therefore serve to fill some of the gaps in treatment that currently exist.
Improving the health of Indigenous Australians
A total of 1,000 people at multiple centres in Australia will participate in the trial. In keeping with The George Institute’s commitment to improving the health of Indigenous Australians, who have very high rates of cardiovascular disease, more than half of the trial group will be drawn from Indigenous communities. Recruitment of patients for the trial began in 2009 and the study will take three years to complete. The trial will measure the size of any benefits, and determine whether there are any problems with this treatment strategy, such as reduced ability to individualise treatment regimens. While by no means seen as a ’panacea’ for the prevention of cardiovascular disease, for most disadvantaged communities the prospect of a polypill holds considerable promise for helping people at greatest risk.
