Authors : Andre Lamy, Wesley Tong, Philip Joseph, Peggy Gao, *Prem Pais*, Patricio Lopez-Jaramillo, Marjan Walli-Attaei, Tony Dans, *Denis Xavier*, Shamim Talukder, Anwar Santoso, Habib Gamra, Salim Yusuf, TIPS-3 Investigators
Publication Year : 2021
The International Polycap Study - 3 trial (TIPS-3) demonstrated a polypill containing cholesterol-and multiple blood pressure lowering drugs reduces cardiovascular events by 20% compared to placebo in people without cardiovascular disease. Polypill plus aspirin led to a 31% RRR in CVD events compared to double placebo. We report regional variations in costs and affordability of a polypill based on the TIPS-3 trial. METHODS &
Countries were categorized using World Bank economic groups Lower Middle Income Countries, Upper Middle Income Countries and High Income Countries. Country specific costs were obtained for hospitalized events, procedures, and non-study medications (2019 USD). Polypill price was based on the cheapest equivalent substitute (CES) for each component. For the polypill versus placebo the difference in cost over the 4.6 years of the trial was ${\$}$291 (95% CI ${\$}$243 to ${\$}$339) per participant in Lower Middle Income Countries, ${\$}$1,068 (95% CI ${\$}$992 to ${\$}$1,144) in Upper Middle Income Countries and ${\$}$48 (95% CI -${\$}$271 to ${\$}$367) in High Income Countries. Results were similar for polypill plus aspirin versus a double placebo. In both cases, the polypill was affordable in all groups using monthly household capacity to pay or a threshold of 4% of the Gross National Income per capita.
The use of a polypill (CES) in TIPS-3 increases costs in Lower Middle Income Countries and Upper Middle Income Countries but is affordable in countries at various economic levels and is cost-neutral (dominant) in High Income Countries.
https://pesquisa.bvsalud.org/portal/resource/en;/mdl-34962984