Why is there more heat than light concerning the polypill?

doi:10.1136/bmj.a2162

Published 20 October 2008, doi:10.1136/bmj.a2162
Cite this as: BMJ 2008;337:a2162

Letters

What happened to the polypill?

Why is there more heat than light concerning the polypill?

The first 150 words of the full text of this article appear below.

Watts’s question—why are there still so few polypilltrials?—is reasonable.¹

In 2001 epidemiologist Richard Peto facilitated a meeting betweenthe World Health Organization and the Wellcome Trust to discussdevelopment of fixed dose combination products in secondaryprevention of cardiovascular disease.² Yusuf noted the potentialfor a combination treatment to reduce cardiovascular risk bythree quarters in the Lancet in 2002.³ Wald and Law summarisedthe evidence and proposed the polypill concept, including widespreaduse for primary prevention, in the widely cited BMJ papers in2003.⁴ Yet late in 2008 there are few trials, all in early stages.How could this be?

The big issue is not the finer points of the initial targetpopulation, the pill components, or professional opinion onthe right balance between the perfect and the possible. Thebig issue is the huge gap in funding for research and developmentof affordable "applied innovations." Formulation, manufacture,. . . [Full text of this article]

Anthony Rodgers, professor¹, Anushka Patel, director²

¹ School of Population Health, University of Auckland, PB92019, Auckland, New Zealand, ² Cardiovascular Division, George Institute for International Health, University of Sydney, Sydney, NSW 2000, Australia

a.rodgers@auckland.ac.nz