Dr. Kevin Most: Poly Pills

Dr. Kevin Most and Steve Cochran

Late last month the results of a study done in Iran and published , now many may think this is taking things to an extreme for convenience, but in fact science has shown that this may be the future of some common combination medications. The study showed that a poly pill actually had an impact on heart disease in lower income countries. What is a poly pill?  This study looked at patients that were given a single pill, that contained, aspirin, a statin for cholesterol, a diuretic, and another medication for blood pressure and heart protection. It contained 4 medications and was taken once a day. The premise behind this is to make it as simple as possible to deliver the correct drugs in a single setting, not worrying about forgetting one or having one prescription run out before the others and missing a dose much more likely. This study compared 2 groups, one that took the poly pill and one group took the 4 pills individually. The study showed that not only was compliance much higher in the group that took the single medication but the incidence of heart attack and stroke was significantly lower.

This same study was just completed in the United States and the results were even more convincing. In the US the poly pill contained 4 lower dose medications that treated cholesterol and high blood pressure. The study was completed in Mobile, Alabama. The results of the US study showed a 25 per cent decrease in the cardiovascular risk for the individuals taking the poly pill versus the control group. This study was done with patients from a low income clinic in the city. The impact was really noted in individuals who did not have a current diagnosis of heart disease, it showed a 40% decrease in these individuals advancing to heart disease, however even those with advanced heart disease saw a 20% decrease in cardiac related incidents.

What is of interest is that researchers are now looking at the ability to actually lower the strength of medication needed to get the optimal results when taken as a poly pill. When taken individually that study is much harder to do. So we may see individuals benefit from better outcomes  while also being exposed to lower doses of medications. One would also expect to see a lower cost overall as the pharmacy labor would be down as would delivery costs.

This may be the way of the future as income may impact the ability to obtain the medications but compliance still comes down to making sure no doses are missed and that concern crosses all income brackets. Look for more of these poly pills to come out as researchers search records for common combinations of medications.

Increased compliance, lower strength of medications, lower costs and better outcomes is hard to argue against.

Fortunately those days are gone and most medications are once or twice a day. Even medications that need to be taken twice a day have a significantly lower compliance rate than the one time a day dosing.

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