title: A 'polypill' aimed at preventing cardiovascular disease could prove highly cost-effective for use in Latin America.
abstract: We evaluated the cost-effectiveness of administering a daily "polypill" consisting of three antihypertensive drugs, a statin, and aspirin to prevent cardiovascular disease among high-risk patients in Latin America. We found that the lifetime risk of cardiovascular disease could be reduced by 15 percent in women and by 21 percent in men if the polypill were used by people with a risk of cardiovascular disease equal to or greater than 15 percent over ten years. Attaining this goal would require treating 26 percent of the population at a cost of $34-$36 per quality-adjusted life-year. Offering the polypill to women at high risk and to men age fifty-five or older would be the best approach and would yield acceptable incremental cost-effectiveness ratios. The polypill would be very cost-effective even in the country with the lowest gross national income in our study. However, policy makers must weigh the value of intervention with the polypill against other interventions, as well as their country's willingness and ability to pay for the intervention.
authors.affiliation: Department of Population Health Sciences, the University of Wisconsin-Madison, WI, USA. lebautista@wisc.edu
authors.forename: Leonelo E
authors.initials: LE
authors.lastname: Bautista
authors.forename: Lina M
authors.initials: LM
authors.lastname: Vera-Cala
authors.forename: Daniel
authors.initials: D
authors.lastname: Ferrante
authors.forename: Víctor M
authors.initials: VM
authors.lastname: Herrera
authors.forename: J Jaime
authors.initials: JJ
authors.lastname: Miranda
authors.forename: Rafael
authors.initials: R
authors.lastname: Pichardo
authors.forename: José R
authors.initials: JR
authors.lastname: Sánchez Abanto
authors.forename: Catterina
authors.initials: C
authors.lastname: Ferreccio
authors.forename: Eglé
authors.initials: E
authors.lastname: Silva
authors.forename: Myriam
authors.initials: M
authors.lastname: Oróstegui Arenas
authors.forename: Julio A
authors.initials: JA
authors.lastname: Chirinos
authors.forename: Josefina
authors.initials: J
authors.lastname: Medina-Lezama
authors.forename: Cynthia M
authors.initials: CM
authors.lastname: Pérez
authors.forename: Norberto
authors.initials: N
authors.lastname: Schapochnik
authors.forename: Juan P
authors.initials: JP
authors.lastname: Casas
mesh_terms: D000368:Aged; D000959:Antihypertensive Agents / Q000008:administration & dosage* / Q000191:economics*; D001241:Aspirin / Q000008:administration & dosage* / Q000191:economics*; D001262:Atenolol / Q000008:administration & dosage / Q000191:economics; D002318:Cardiovascular Diseases / Q000191:economics / Q000517:prevention & control*; D015331:Cohort Studies; D003362:Cost-Benefit Analysis; D003906:Developing Countries; D004338:Drug Combinations; D005260:Female; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000008:administration & dosage* / Q000191:economics*; D007843:Latin America; D008297:Male; D008390:Markov Chains; D008875:Middle Aged; D019057:Quality-Adjusted Life Years; D017257:Ramipril / Q000008:administration & dosage / Q000191:economics; D016032:Randomized Controlled Trials as Topic; D012307:Risk Factors; D019821:Simvastatin / Q000008:administration & dosage* / Q000191:economics*; D049993:Sodium Chloride Symporter Inhibitors / Q000008:administration & dosage / Q000191:economics
chemical_list: D000959:Antihypertensive Agents; D004338:Drug Combinations; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D049993:Sodium Chloride Symporter Inhibitors; D001262:Atenolol; D019821:Simvastatin; D017257:Ramipril; D001241:Aspirin