EDITOR—Your correspondents overlook the extent of the health gain achievable with the “Polypill” and of the large amount of evidence underpinning our estimates of efficacy and adverse effects.1

About one person in three would benefit, and the Polypill would offer many people important extra years of active and useful life, with benefits evident over decades. The adverse effects, on the other hand, would mostly be apparent after a few weeks, in which case a variant of the pill could be substituted—for example, one without aspirin.

Of course, the Polypill is not an alternative to adopting a healthy lifestyle such as not smoking or not becoming overweight: it is a complementary means of prevention. We agree that work on the Polypill needs to continue so that after the necessary clinical trials it can be made available.

Ramos's view, that medicine should remain a patient based practice, is too limited; it would forgo important …