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Experts warn over "polypillomania"

Experts have warned that efforts to create a single polypill to cut the risk of cardiovascular disease has become "an idea in danger of becoming a solution that's desperately seeking a problem, rather than the other way round".

An editorial in the new look Drug and Therapeutics Bulletin (DTB) - prompted by the announcement last month of a viability test on a new polypill combination - said that medical professionals and journalists are now in the grip of "polypillomania".

The concept of a single pill containing a statin to tackle cholesterol, aspirin, and other drugs, such as an ACE inhibitor and a beta blocker, was first put forward in 2003, and DTB says the idea has maintained an "almost magical" hold over individuals ever since.

Polypill advocates argue that a combination of several drugs already proven to work well individually could prove cheaper and help people stick to treatment better.

But DTB contends: "However, the reality turns out to be not so straightforward, not least because we seem to have moved into the world of poly polypills."

Trials carried out to date have targeted different groups of people, contained different types and doses of constituent drugs, and measured different outcomes, and DTB said: "It would seem that the original concept of a simple solution to a common problem has mutated into testing an increasingly complex range of potential products for multiple patient populations."

Copyright © Press Association 2011

Drug and Therapeutics Bulletin

We asked you to tell us if you think medical professionals are in the grip of "polypillomania". Your comments (terms and conditions apply):

"Two points here - pharma companies only make money if after up to 15 years' time, effort and around £250 million financial investment, actually results in a prescribable medicine. The NHS invests virtually nothing in
the development of new compounds. Secondly, concordance/adherence to medication is a great problem in the UK with up to 60% of the total drug budget wasted or not put to good use. I agree fully that individualised care is essential, as well as full partnership between clinicians and patients BUT with government 'targets' dictating that all risk factors must be addressed and modified, polypharmacy is here to stay and patients need all the support they can to adhere to regimes and benefit from treatment" - Kathleen McGrath, London

"The only people who would truly benefit from this idea of mass medication are the pharmaceutical companies" - Nurse, Lancs

"Having one tablet to cover varied conditions is a good idea for those not compliant with polypharmacy and who are shy, scared, or feel burdened by counting so many drugs but can such a move really offer individualised dosages? What if you have x amount of drugs that fit well but cholesterol for that person is high and require more, could that combination be readily available? That is to say can the polypill be made in different strengths according to standard treatment guidelines?" - Jimmy Jombla, London