OBJECTIVES:

To assess the cost-effectiveness and cost-utility of ASA 100 mg, simvastatin 40 mg and ramipril 5-10 mg (polypill), in comparison with its individual components for the secondary prevention of cardiovascular events in patients with and without recent history of myocardial acute infarction, from the perspective of private health institutions in Mexico.

METHODS:

An economic Markov model was developed to analyze the cost-effectiveness and cost-utility of the polypill versus its individual components. The effectiveness outcomes were expressed as life years gained and quality-adjusted life years (QALY), associated with the benefits of adherence to the polypill. The study was conducted over a 20-year horizon, with a discount rate of 5%, taking the costs from the maximum sale price to the public. The direct medical cost taken into consideration were: pharmacological costs, acute and chronic adverse events costs, as well as hospitalization costs. Finally, a deterministic and probabilistic sensitivity analysis was performed.

RESULTS:

The results of the economic evaluation showed that 5.76 life years gained and 4.79 QALYs are obtained when using the polypill, while with the individual components, the numbers are 5.75 and 4.77, per patient. Hence, the polypill was more effective, with an increase of 0.015 life years gained and 0.014 QALYs. The total mean cost per patient was € 13,484 with the polypill and € 15,900 with the individual components, which results in savings of € 2,416.

CONCLUSIONS:

The polypill is a dominant option, since it provides more health benefits (life years gained and QALY), as well as savings when compared to the individual components from the perspective of private health institutions in Mexico. It was also proven with the sensitivity analysis that the economic model is robust in conditions of uncertainty.