OBJECTIVES: The SECURE randomized controlled trial (NCT02596126) compared a CV polypill (ASA + atorvastatin + ramipril) versus the individual components administered separately, in reducing MACE after a myocardial infarction (MI). The trial showed a 24% reduction in the relative risk of the primary endpoint (MI, ischemic stroke [IS], urgent revascularization, and CV death), over 4 years.

This analysis aimed to estimate, through modelling, the potential MACE reduction and economic savings of adopting the CV polypill in Spain, compared to the individual components, considering the annual MI incidence, over a 4-year time horizon.

METHODS: The annual non-fatal MI incidence in Spain was estimated at 36,539, combining data from the RECALCAR 2023 Registry (50,002 MI cases in 2021) and the National Institute of Statistics (13,463 MI deaths in 2021).

The probability of experiencing MI, IS and CV death was estimated from the SECURE study and applied to the simulated patient cohorts, consisting of the annually incident patients, over a 4-year time horizon. A new incident cohort was simulated each year. The number of patients at risk was adjusted over time according to the overall survival observed in SECURE.

Hospitalization costs (2021) sourced from the Spanish Ministry of Health were: non-fatal MI (€6,288), non-fatal IS (€5,204). CV death cost was €11,871, calculated from fatal MI (€12,026) and IS (€7,473) events, with the SECURE study proportions (MI: 96.6%, IS: 3.4%).

RESULTS: The adoption of the CV polypill could result in the avoidance of 3,062 MI, 1,557 IS, and 5,086 CV deaths in Spain over a 4-year period. The savings in direct hospitalization costs were estimated to be €87,731,955.

CONCLUSIONS: Adopting the CV polypill in post-MI patients has the potential to prevent 9,705 MACE in Spain over 4 years, saving €87.7 million for the NHS, making it the preferred therapeutic option at discharge after a MI.