What if instead of remembering to take four or five pills at different times throughout the day, a pharmacist could hand you just one?
That’s the idea behind the polypill, a 4-in-1 or 5-in-1 pill being developed by researchers at the Population Health Research Institute (PHRI). They hope that it will be easier for patients to access all the medications they need, and to take them more consistently.
“Cardiovascular risk factors track,” says occupational therapist Jackie Bosch. “That means people who have high blood pressure tend to have elevated cholesterol, or a little bit elevated cholesterol. They tend to have issues with their blood. So they tend to take a variety of medications.”
And if many patients are taking the same four or five pills every day, it starts to make a lot of sense to combine them into a single formulation. Taking a single pill each day is easier for patients, and their outcomes improve when they take the complete regimen regularly.
“We’ve worked with a company to produce a combination pill: three blood pressure lowering agents, a statin, and if needs be, an aspirin as well. It’s a 4-in-1 pill or a 5-in-1 pill,” says cardiologist Salim Yusuf, Executive Director at PHRI.
“It is true that it’s a very simple concept, but the reason why it hasn’t existed was that different companies manufacture different drugs. So they don’t really talk to each other, especially during the time when the drug is still on patent.”
Unfortunately, there is little economic incentive for drug companies to pursue combination therapies like the polypill. Once drugs are off patent and can be manufactured as generics, the revenues they can bring in are relatively modest. But the rewards for patients could change lives.
“This is almost a no brainer,” adds Yusuf. “It should be done, and it’ll have a big impact.”
On the flip side, generic drugs are much more affordable, meaning that the polypill project has the potential to reach patients in low-income countries where access to treatment can be challenging.
“The interesting thing about a polypill is once the drugs go generic, it becomes extremely inexpensive to create, and therefore people who never had access to drugs before can actually obtain these medications,” explains Bosch.
“So we’re running that study in places like India, the Philippines, Bangladesh, Indonesia, Tunisia, Malaysia, because we think that these are the places that will benefit the most, and the people who may benefit the most.”
We know that combination therapies are the best option for treating patients with cardiovascular disease, but in clinical practice, many patients don’t receive the full set of medications. The polypill could provide the ease and accessibility that changes the global standard of care.