Cost-effectiveness of the CV-polypill strategy versus standard care for secondary cardiovascular prevention in Spain: an analysis based on the SECURE trialResearch in context
Summary: 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...
Saved in:
| Main Authors: | , , , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Elsevier
2025-08-01
|
| Series: | The Lancet Regional Health. Europe |
| Subjects: | |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S2666776225001401 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1849433520306388992 |
|---|---|
| author | Thomas Gaziano José María Castellano Amy Dymond Alissa Looby Stuart Mealing Ruth Owen Stuart Pocock José Ramón González-Juanatey Alberto Cordero Antonio Fernández-Ortiz Aleš Linhart François Schiele Wolfram Doehner Luisa Ojeda Fernández Valentín Fuster |
| author_facet | Thomas Gaziano José María Castellano Amy Dymond Alissa Looby Stuart Mealing Ruth Owen Stuart Pocock José Ramón González-Juanatey Alberto Cordero Antonio Fernández-Ortiz Aleš Linhart François Schiele Wolfram Doehner Luisa Ojeda Fernández Valentín Fuster |
| author_sort | Thomas Gaziano |
| collection | DOAJ |
| description | Summary: 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. |
| format | Article |
| id | doaj-art-b215da2079e04f08aff3c03894f89bc4 |
| institution | Kabale University |
| issn | 2666-7762 |
| language | English |
| publishDate | 2025-08-01 |
| publisher | Elsevier |
| record_format | Article |
| series | The Lancet Regional Health. Europe |
| spelling | doaj-art-b215da2079e04f08aff3c03894f89bc42025-08-20T03:27:01ZengElsevierThe Lancet Regional Health. Europe2666-77622025-08-015510134810.1016/j.lanepe.2025.101348Cost-effectiveness of the CV-polypill strategy versus standard care for secondary cardiovascular prevention in Spain: an analysis based on the SECURE trialResearch in contextThomas Gaziano0José María Castellano1Amy Dymond2Alissa Looby3Stuart Mealing4Ruth Owen5Stuart Pocock6José Ramón González-Juanatey7Alberto Cordero8Antonio Fernández-Ortiz9Aleš Linhart10François Schiele11Wolfram Doehner12Luisa Ojeda Fernández13Valentín Fuster14Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USACentro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, SpainYork Health Economics Consortium (YHEC), York, United Kingdom; Corresponding author. York Health Economics Consortium, Enterprise House, Innovation Way, University of York, York, YO10 5NQ, United Kingdom.York Health Economics Consortium (YHEC), York, United KingdomYork Health Economics Consortium (YHEC), York, United KingdomCentro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; London School of Hygiene and Tropical Medicine, London, United KingdomCentro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; London School of Hygiene and Tropical Medicine, London, United KingdomHospital Clínico Universitario de Santiago de Compostela, IDIS, CIBERCV, Santiago de Compostela, SpainCardiology Department, Hospital Universitario de San Juan, Alicante, SpainHospital Clinico San Carlos, Idissc, Universidad Complutense, Madrid, SpainVšeobecná Fakultní Nemocnice v Praze, Prague, Czech RepublicCentre Hospitalier Régional Universitaire de Besançon - Hôpital Jean Minjoz, University of Franche Comte SINERGIES, Besancon, FranceBerlin Institute of Health Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Berlin, Germany; Deutsches Herzzentrum der Charité, Department Cardiology (Virchow Klinikum), Charité - Universitätsmedizin Berlin, - German Centre for Cardiovascular Research Partner Site Berlin, Germany; Center for Stroke Research Berlin, Charité - Universitätsmedizin Berlin, Berlin, GermanyLaboratory of Cardiovascular Prevention, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, ItalyCentro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain; Mount Sinai Fuster Heart Hospital, The Mount Sinai Hospital, New York, USASummary: 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.http://www.sciencedirect.com/science/article/pii/S2666776225001401Cost-effectiveness analysisCardiovascular preventionCV-Polypill |
| spellingShingle | Thomas Gaziano José María Castellano Amy Dymond Alissa Looby Stuart Mealing Ruth Owen Stuart Pocock José Ramón González-Juanatey Alberto Cordero Antonio Fernández-Ortiz Aleš Linhart François Schiele Wolfram Doehner Luisa Ojeda Fernández Valentín Fuster Cost-effectiveness of the CV-polypill strategy versus standard care for secondary cardiovascular prevention in Spain: an analysis based on the SECURE trialResearch in context The Lancet Regional Health. Europe Cost-effectiveness analysis Cardiovascular prevention CV-Polypill |
| title | Cost-effectiveness of the CV-polypill strategy versus standard care for secondary cardiovascular prevention in Spain: an analysis based on the SECURE trialResearch in context |
| title_full | Cost-effectiveness of the CV-polypill strategy versus standard care for secondary cardiovascular prevention in Spain: an analysis based on the SECURE trialResearch in context |
| title_fullStr | Cost-effectiveness of the CV-polypill strategy versus standard care for secondary cardiovascular prevention in Spain: an analysis based on the SECURE trialResearch in context |
| title_full_unstemmed | Cost-effectiveness of the CV-polypill strategy versus standard care for secondary cardiovascular prevention in Spain: an analysis based on the SECURE trialResearch in context |
| title_short | Cost-effectiveness of the CV-polypill strategy versus standard care for secondary cardiovascular prevention in Spain: an analysis based on the SECURE trialResearch in context |
| title_sort | cost effectiveness of the cv polypill strategy versus standard care for secondary cardiovascular prevention in spain an analysis based on the secure trialresearch in context |
| topic | Cost-effectiveness analysis Cardiovascular prevention CV-Polypill |
| url | http://www.sciencedirect.com/science/article/pii/S2666776225001401 |
| work_keys_str_mv | AT thomasgaziano costeffectivenessofthecvpolypillstrategyversusstandardcareforsecondarycardiovascularpreventioninspainananalysisbasedonthesecuretrialresearchincontext AT josemariacastellano costeffectivenessofthecvpolypillstrategyversusstandardcareforsecondarycardiovascularpreventioninspainananalysisbasedonthesecuretrialresearchincontext AT amydymond costeffectivenessofthecvpolypillstrategyversusstandardcareforsecondarycardiovascularpreventioninspainananalysisbasedonthesecuretrialresearchincontext AT alissalooby costeffectivenessofthecvpolypillstrategyversusstandardcareforsecondarycardiovascularpreventioninspainananalysisbasedonthesecuretrialresearchincontext AT stuartmealing costeffectivenessofthecvpolypillstrategyversusstandardcareforsecondarycardiovascularpreventioninspainananalysisbasedonthesecuretrialresearchincontext AT ruthowen costeffectivenessofthecvpolypillstrategyversusstandardcareforsecondarycardiovascularpreventioninspainananalysisbasedonthesecuretrialresearchincontext AT stuartpocock costeffectivenessofthecvpolypillstrategyversusstandardcareforsecondarycardiovascularpreventioninspainananalysisbasedonthesecuretrialresearchincontext AT joseramongonzalezjuanatey costeffectivenessofthecvpolypillstrategyversusstandardcareforsecondarycardiovascularpreventioninspainananalysisbasedonthesecuretrialresearchincontext AT albertocordero costeffectivenessofthecvpolypillstrategyversusstandardcareforsecondarycardiovascularpreventioninspainananalysisbasedonthesecuretrialresearchincontext AT antoniofernandezortiz costeffectivenessofthecvpolypillstrategyversusstandardcareforsecondarycardiovascularpreventioninspainananalysisbasedonthesecuretrialresearchincontext AT aleslinhart costeffectivenessofthecvpolypillstrategyversusstandardcareforsecondarycardiovascularpreventioninspainananalysisbasedonthesecuretrialresearchincontext AT francoisschiele costeffectivenessofthecvpolypillstrategyversusstandardcareforsecondarycardiovascularpreventioninspainananalysisbasedonthesecuretrialresearchincontext AT wolframdoehner costeffectivenessofthecvpolypillstrategyversusstandardcareforsecondarycardiovascularpreventioninspainananalysisbasedonthesecuretrialresearchincontext AT luisaojedafernandez costeffectivenessofthecvpolypillstrategyversusstandardcareforsecondarycardiovascularpreventioninspainananalysisbasedonthesecuretrialresearchincontext AT valentinfuster costeffectivenessofthecvpolypillstrategyversusstandardcareforsecondarycardiovascularpreventioninspainananalysisbasedonthesecuretrialresearchincontext |