Cost-effectiveness of the CV-polypill strategy versus standard care for secondary cardiovascular prevention in Spain: an analysis based on the SECURE trial
Status PubMed-not-MEDLINE Language English Country Great Britain, England Media electronic-ecollection
Document type Journal Article
PubMed
40678039
PubMed Central
PMC12269512
DOI
10.1016/j.lanepe.2025.101348
PII: S2666-7762(25)00140-1
Knihovny.cz E-resources
- Keywords
- CV-Polypill, Cardiovascular prevention, Cost-effectiveness analysis,
- Publication type
- Journal Article MeSH
BACKGROUND: The SECURE trial (NCT02596126) demonstrated the efficacy of the cardiovascular polypill ("CV-Polypill"-acetyl salicylic acid, atorvastatin and ramipril) in reducing the risk of recurrent major cardiovascular events compared with standard care when initiated within six months of a myocardial infarction. This analysis aimed to estimate the cost-effectiveness of the CV-Polypill from the Spanish healthcare perspective using SECURE trial data. METHODS: A decision analytic Markov modelling approach was conducted to compare the CV-Polypill with standard care over a lifetime time horizon. Six parametric distributions were fitted to SECURE trial data on time to reinfarction, stroke or death (cardiovascular or non-cardiovascular). Cost and utility data were sourced from literature. Respective model outputs were discounted at 3%. The model captured direct medical costs associated with treatment acquisition and acute/ongoing cardiovascular events. Probabilistic sensitivity analyses (PSA) and scenario analyses were conducted. FINDINGS: The CV-Polypill is dominant (improves health outcomes and reduces costs) in 84·8% of PSA iterations (848/1000 iterations), and cost effective in 89·3% of PSA iterations (893/1000 iterations) at a €30,000 threshold. Secondary prevention with the CV-Polypill reduces the recurrence of cardiovascular events and costs over the time horizon, from the Spanish healthcare perspective. A range of scenario analyses were conducted, demonstrating the robustness of the results when different inputs and assumptions were varied. INTERPRETATION: The CV-Polypill is a dominant strategy in secondary cardiovascular prevention, compared with standard care, from the Spanish healthcare perspective. The CV-Polypill should be considered as a secondary prevention for Spanish patients, like those enrolled in SECURE, at hospital discharge. FUNDING: By Ferrer International.
Brigham and Women's Hospital Harvard Medical School Boston MA USA
Cardiology Department Hospital Universitario de San Juan Alicante Spain
Center for Stroke Research Berlin Charité Universitätsmedizin Berlin Berlin Germany
Centro Nacional de Investigaciones Cardiovasculares Madrid Spain
Hospital Clinico San Carlos Idissc Universidad Complutense Madrid Spain
Hospital Clínico Universitario de Santiago de Compostela IDIS CIBERCV Santiago de Compostela Spain
London School of Hygiene and Tropical Medicine London United Kingdom
Mount Sinai Fuster Heart Hospital The Mount Sinai Hospital New York USA
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