Buzzword: Polypill

Consumer Reports News: April 08, 2009 04:14 PM

My morning routine includes choking down a healthy fistful of prescription pills. There are three to help keep my type-2 diabetes under control. There’s one for my blood pressure. There’s another one to help lower my cholesterol. Another keeps something called GERD, or gastroesophageal reflux disease, at bay. Whenever I am on an antibiotic or something else, it is hard to get the lids closed on my seven-day pill organizer. So it’s easy to understand why my ears perked up recently when I heard about something called the polypill.

Pills What does it mean? A polypill is a single pill containing a number of key drugs that are widely used to help lessen the risk of heart attacks, strokes, or other medical problems. For example, polypills for cardiovascular diseases have been developed that contain aspirin, blood pressure and cholesterol drugs. The polypill concept has been around for awhile and some clinical trial work is being done, but it’s unclear when or if any of these polypills will ever make it to market.

Why the buzz? Polypills have jumped into the headlines recently after a 12-week clinical study conducted in India was published in a leading medical journal claiming a five-drug polypill was safe and about as effective as each medication given alone. Proponents of polypills say they could save millions of lives—particularly in low- and middle-income countries—by potentially lowering the cost of proven treatments such as ACE inhibiters, beta blockers, and statins. In addition, supporters say polypills could cut health care costs dramatically by helping reduc,e cardiovascular disease—one of the world’s costliest medical problems. Even in developed countries, proponents say, offering patients a single pill to replace several they should or do take would help increase compliance with their doctor's orders.

Not everyone is convinced that polypills are a great idea, however. Some critics argue polypills will be too large for many people to swallow and that there will be adverse effects and drug interactions with other medications. Also, a disadvantage of the polypill might be difficulty in adjusting the dose of one or more of the components. Another problem would be in gaining FDA approval since the polypill would be considered a new drug. Lastly, there is criticism that polypills will lure patients into a false sense of security and will discourage them from losing weight, giving up smoking, or other healthy lifestyle changes.

Essential Reading

The Lancet 

New England Journal of Medicine

Bob Williams, strategic resource director, Consumers Union

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