The polypill and medicines access: two decades and counting

There have been two landmarks in 2023 for the polypill: one momentous, the other sobering. The momentous event is the inclusion—after several attempts—of polypills for high risk primary and secondary prevention of cardiovascular disease in the World Health Organization (WHO) List of Essential Medicines.1 This is important as more than 90% of people in the world with cardiovascular disease still don’t receive the antiplatelet, statin, and blood pressure lowering medicines that evidence showed to be effective over 30 years ago.2 Availability and affordability are particular challenges in low and middle income countries, where most people with cardiovascular disease live.23 Cardiovascular disease caused 393 million lost healthy life years in 2019—15% of total global disease burden—compared with 312 million (12% of total) 20 years earlier.4 Most premature deaths can be prevented with access to essential cardiovascular medicines.5The second landmark is the 20 year anniversary of the seminal “polypill papers” in The…
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