Abstract
Cardiovascular disease (CVD) is the leading cause of mortality globally. Most people with cardiovascular disease do not take long-term cholesterol-lowering, anti-platelet and blood pressure-lowering medications despite proven benefits. Fixed-dose combination pills (‘polypills’) have been shown to improve adherence to these recommended medications with corresponding improvements in risk factors such as blood pressure and low-density lipoprotein (LDL) cholesterol. Among patients not taking the full complement of recommended CVD preventive therapies, use of a polypill-based strategy (i.e. initiating treatment with single-pill combination medication then titrating further therapy as needed) has large potential benefits in reducing global morbidity and mortality. Despite this, few polypills are available on the market due to market failure in the funding of research and development for affordable non-communicable disease medicines. Additionally, defining a path to market has been problematic in that fixed-dose combinations with multiple different drug classes included are quite novel, and regulatory processes to review these types of applications are not well established. Despite these delays, progress is slowly being made.
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Acknowledgements
The authors have received grants from several research charities and national funding agencies for research on cardiovascular fixed-dose combination medications and from Dr. Reddys Ltd for co-ordination of the SPACE programme. The George Institute for Global Health obtained an exclusive global license in Dec 2012 for the fixed-dose combinations used in the SPACE trials following a decision by Dr. Reddy’s Ltd not to proceed with taking the products to market because of uncertainty in regulatory requirements.
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Anthony Rodgers is supported by an NHMRC Principle Research Fellowship. Ruth Webster is supported by a Heart Foundation of Australia post-doctoral fellowship.
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This article does not contain any studies with human or animal subjects performed by any of the authors.
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This article is part of the Topical Collection on Public Health Policy
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Webster, R., Rodgers, A. Polypill: Progress and Challenges to Global Use—Update on the Trials and Policy Implementation. Curr Cardiol Rep 17, 121 (2015). https://doi.org/10.1007/s11886-015-0673-x
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DOI: https://doi.org/10.1007/s11886-015-0673-x