Usefulness of a Cardiovascular Polypill in the Treatment of Secondary Prevention Patients in Spain: A Cost-effectiveness Study

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• 作者：Vivencio Barrios^a ; ^{vivenciobarrios@gmail.com} ; Lisette Kaskens^b ; José ; Marí ; a Castellano^c ; ^d ; ^e ; Juan Cosin-Sales^f ; José ; Emilio Ruiz^b ; Ilonka Zsolt^b ; Valentí ; n Fuster^c ; ^d ; Alfredo Gracia^b
• 关键词：Prevenció ; n secundaria cardiovascular ; Policomprimido ; Adherencia ; Coste-efectividad
• 刊名：Revista Española de Cardiología (English Edition)
• 出版年：2017
• 出版时间：January 2017
• 年：2017
• 卷：70
• 期：1
• 页码：42-49
• 全文大小：546 K
• 卷排序：70

文摘

To estimate the health benefits and cost-effectiveness of a polypill intervention (aspirin 100 mg, atorvastatin 20 mg, ramipril 10 mg) compared with multiple monotherapy for secondary prevention of cardiovascular events in adults with a history of myocardial infarction from the perspective of the Spanish National Health System.MethodsAn adapted version of a recently published Markov model developed and validated in Microsoft Excel was used to compare the cost-effectiveness of the polypill with that of its combined monocomponents over a 10-year time horizon. The population included in the model had a mean age of 64.7 years; most were male and had a history of myocardial infarction. The input parameters were obtained from a systematic literature review examining efficacy, adherence, utilities, and costs. The results of the model are expressed in events avoided, incremental costs, incremental life years, incremental quality-adjusted life years, and the incremental cost-effectiveness ratio.ResultsOver a 10-year period, use of the cardiovascular polypill instead of its monocomponents simultaneously would avoid 46 nonfatal and 11 fatal cardiovascular events per 1000 patients treated. The polypill would also be a more effective and cheaper strategy. Probabilistic analysis of the base case found a 90.9% probability that the polypill would be a cost-effective strategy compared with multiple monotherapy at a willingness-to-pay of 30 000 euros per quality-adjusted life year.ConclusionsThe polypill would be a cost-effective strategy for the Spanish National Health System with potential clinical benefits.