OBJECTIVES:

There are approximately 7 million people living with CVD in the UK, with an estimated impact on healthcare costs of £11 billion per year. The National Institute for Health and Care Excellence (NICE) recommends that patients with CVD are prescribed medications including statins, blood pressure lowering therapies and anticoagulants. However, most do not take recommended medications on a long-term basis. Reasons for this can include the complexity of the medication regimen. One way to simplify the medication regimen would be to introduce a CVD polypill. The ‘Use of a Multi-drug Pill in Reducing Cardiovascular Events’ (UMPIRE) clinical trial compared a polypill to usual care in patients with or at high risk of CVD. We used the outcomes from this trial to investigate the long-term impact of introducing the polypill in an NHS setting.

METHODS:

We developed a discrete event simulation model to model the cost-effectiveness of a polypill (comprising of an aspirin, statin and 2 antihypertensive medications) compared to usual care (single medications). The 2011 Health Survey for England dataset was used to derive our model population and an estimate of adherence to medication in usual care. We used data from the UMPIRE trial to model the long-term effect of a polypill on medication adherence compared to usual care. We allowed for medication adherence to vary over time as people aged and had CVD events such as stroke or heart attack. We simulated a lifetime in both scenarios for each individual and estimated lifetime costs and qualify adjusted life years (QALYs)

RESULTS:

Introducing a CVD polypill into an NHS setting results in cost savings of £1,555,000 and a gain of 27 QALYs per 10,000 persons.

CONCLUSIONS:

The introduction of a polypill would provide patients with a simpler medication regime and increase treatment effectiveness with a subsequent downstream effect on healthcare costs.