September 2, 2006

Spain May Lead World with Heart ‘Polypill’ in 2009

By Ben Hirschler, European Pharmaceuticals Correspondent

BARCELONA -- Spain could lead the world with the launch in 2009 or 2010 of the first three-in-one "polypill" to prevent heart attacks, a top cardiologist advising on the project said on Saturday.

If successful, the combo pill would be rolled out next in China and then across the globe, giving doctors a new weapon in the battle against heart disease, World Heart Federation President Valentin Fuster said.

The polypill would include generic versions of three established medicines -- a cholesterol-lowering statin, an ACE inhibitor for reducing blood pressure and aspirin -- and would be given to patients who had already experienced a heart attack.

At the moment, such patients are often required to take multiple drugs, which is expensive. They also frequently forget to take the right medicine at the right time.

"A single pill would be much easier and cheaper," Fuster told reporters on the opening day of the World Congress of Cardiology.

Proponents have long called for a polypill but plans to introduce one have been complicated by rivalry among large drug companies, which are keen to promote their patented products.

Fuster said the new plan would involve medium-sized companies interested in selling a cheaper generic-based medicine.

Spain's cardiology institute is already in discussions with an unnamed mid-sized Spanish company about the venture and Fuster said around a dozen companies were in talks worldwide.

The combination pill will have to win regulatory approval from bodies such as the U.S. Food and Drug Administration (FDA) and European Medicines Agency. But Fuster said the FDA had already shown interest in the project, given the big impact it could have on disease.


Cardiologists aim to raise awareness of the threat posed by heart disease in the developing world at their September 2-6 meeting, which is expected to attract more than 25,000 participants.

Fuster said cheaper interventions such as the polypill would be critical in poorer countries, where cardiovascular disease is growing alarmingly, driven by worsening diets and smoking.

Some 80 percent of heart attacks now occur in low and middle-income countries.

"It's growing dramatically in India, South Asia, China and Indonesia. Nearly 50 percent of deaths now occur in Asia alone," Fuster said.

In total, heart disease cut short an estimated 17.5 million lives last year, making it the world's biggest killer.

Despite the huge toll, however, the United Nations has not included cardiovascular disease among its health-related Millennium Development Goals, a situation the World Heart Federation is lobbying hard to change.

Heart disease is caused by blocked arteries and develops over time by the build-up of cholesterol and fat. The decreased blood supply can lead to a heart attack and death.