A peer-reviewed article by NYU medical student Jonathan Levanthal over at Clinical Correlations makes a convincing argument for polypills – that is, a combination pill that could be administered in place of multiple medications – as a means of avoiding drug noncompliance for the chronically ill. Polypharmacy, Levanthal argues, is a leading cause of this noncompliance:
…a poorly controlled diabetic with other medical comorbidities must not only remember to take numerous pills at different times of the day in relation to meals, but also to inject insulin subcutaneously. The patient must also do fingersticks to monitor blood glucose and then make further dietary or medication adjustments accordingly. The regimen is laborsome. It is no wonder that so many of my patients are noncompliant with their medications.
Levanthal also proposes a preventative polypill containing, say, aspirin, folic acid, antihypertensives, and various other goodies, to be administered to adults over the age of 55. He cites a study suggesting that this “magic bullet” pill could prevent 3.2 million cases of coronary artery disease and 1.7 mission cases of strokes over 10 years.
Levanthal recognizes the potential issues of such a pill (the most obvious being that adverse reactions to one of its elements would render the entire regimen-containng pill unusable or ineffective). However, the simplicity that a polypill would bring to chronically ill people - not to mention the potential savings - makes the proposal one worth considering.