An All-in-One Pill for Heart Care?
International study shows cardiac patients more likely to take their drugs if they're packaged together
"That's outrageous, in terms of improvement," said Dr. David May, chair of the board of governors for the American College of Cardiology.
The polypill group also had lower blood pressure and cholesterol, compared with those taking the individual medications.
The idea of a preventive polypill has been kicking around for some time, May said, but this is the first study he had heard of comparing that kind of pill to existing treatments.
"This particular study I like because they're comparing it to regular therapy with standard agents," May said. "We're not just comparing the polypill to nothing. They're actually comparing it to standard therapy."
There are some drawbacks, however.
"What do you do when a guy gets a rash? You now have to deal with the issue of which component might be causing the difficulty," May noted.
The polypill also reduces doctors' ability to tweak the amount of medication a person is taking if, for instance, more blood pressure control is needed, he added.
"There are individuals who feel very strongly this ought to be the statin we use in this environment or that environment," May said.
And there may be potential problems related to the timing of doses, Fletcher noted.
"Some medications need to be taken at night. In this particular study, the statin drug and the blood pressure drug usually need to be taken at night," he said. "Antiplatelets are often taken in the morning. That's a slight disadvantage for the polypill."
On the other hand, Fletcher said bringing such a pill to the U.S. market could be easy, given that generics were used in the study.
"If there are only two components in a polypill, such as statin and aspirin, it could get on the market faster, probably at least a year or more," he added. "The more complex the pill, the longer it will take."
May noted in addition that patients' drug costs could be reduced if they are prescribed a single pill containing several different generic medications.
"The simplification of the delivery of care we provide to our patients is a significant part of the improvement we can gain by this type of strategy," May said. "Oftentimes we become enamored with the idea of how much improvement we get with this or that medication, on top of the other drugs a patient has been prescribed. The short answer is, if they don't take it, you don't get any improvement."