INTERNATIONAL JOURNAL OF EVIDENCE-BASED MEDICINE
Review Article
Jul 15, 2026 24 14

Cost-Effectiveness of Fixed-Dose Combination Polypills for Secondary Cardiovascular Disease Prevention: A Systematic Review

Obiageri Ihuarulam Okeoma 1,
Adetunji Olawale Adediran 2,
David O. Adeoti 3,
Comfort Ohunene Matthew 4 *
1 Department of Medical Laboratory Science, Faculty of Basic Medical And Applied Sciences, Trinity University, Yaba, Lagos, Nigeria2 Department of Internal Medicine, Faculty of Clinical Science, University College Hospital, Ibadan, Oyo State , Nigeria3 Department of Biomedical Engineering, Faculty of Chemical and Biomedical Engineering, University of New Haven, CT, USA4 Department of Clinical Pharmacy, Faculty of Pharmacy, University of Benin, Benin City, Nigeria* Corresponding Author
International Journal of Evidence-Based Medicine, 1(3), 2026, jebm010, https://doi.org/10.63946/jebm/18966
Publication date: Jul 15, 2026
Full Text (PDF)

ABSTRACT

Background: Cardiovascular disease remains a leading cause of global morbidity and mortality, and long-term secondary prevention is often limited by poor adherence, pill burden, treatment costs, and health system barriers. Fixed-dose combination polypills may simplify treatment by combining multiple cardiovascular medicines into a single formulation, thereby improving adherence and reducing recurrent cardiovascular events.
Objective: This systematic review evaluated the cost-effectiveness of fixed-dose combination polypills compared with usual care, standard therapy, or separate monocomponents for secondary cardiovascular disease prevention across different healthcare and income settings.
Methods: The review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses 2020 guidelines. PubMed, Dimensions AI, ScienceDirect, and the Tufts Cost-Effectiveness Analysis Registry were searched for studies published between January 2015 and December 2025. Eligible studies included economic evaluations involving adults with established cardiovascular disease and reporting incremental cost-effectiveness ratios, cost per quality-adjusted life year, cost per disability-adjusted life year, cost savings, or related economic outcomes. Reporting quality was assessed using the Consolidated Health Economic Evaluation Reporting Standards checklist.
Results: Fourteen records were included, comprising 13 full or partial economic evaluations and one Delphi consensus study with policy-relevant contextual interpretation. Most studies were conducted in high-income countries, particularly Spain, while evidence from low- and middle-income countries was limited. Fixed-dose combination polypills were generally reported as cost-effective or cost-saving, mainly driven by improved medication adherence, reduced pill burden, and prevention of recurrent cardiovascular events. Findings were also influenced by methodological factors such as analytic perspective and time horizon adopted across studies.
Conclusion: Fixed-dose combination polypills may offer economic value for secondary cardiovascular disease prevention, but broader implementation should be guided by local cost-effectiveness, affordability, budget impact, and real-world evidence, especially in low- and middle-income countries.

KEYWORDS

Vent Polypill Fixed-Dose Combination Therapy Cost-Effectiveness Cardiovascular Diseases Secondary Prevention

CITATION (Vancouver)

Okeoma OI, Adediran AO, Adeoti DO, Matthew CO. Cost-Effectiveness of Fixed-Dose Combination Polypills for Secondary Cardiovascular Disease Prevention: A Systematic Review. International Journal of Evidence-Based Medicine. 2026;1(3):jebm010. https://doi.org/10.63946/jebm/18966
APA
Okeoma, O. I., Adediran, A. O., Adeoti, D. O., & Matthew, C. O. (2026). Cost-Effectiveness of Fixed-Dose Combination Polypills for Secondary Cardiovascular Disease Prevention: A Systematic Review. International Journal of Evidence-Based Medicine, 1(3), jebm010. https://doi.org/10.63946/jebm/18966
Harvard
Okeoma, O. I., Adediran, A. O., Adeoti, D. O., and Matthew, C. O. (2026). Cost-Effectiveness of Fixed-Dose Combination Polypills for Secondary Cardiovascular Disease Prevention: A Systematic Review. International Journal of Evidence-Based Medicine, 1(3), jebm010. https://doi.org/10.63946/jebm/18966
AMA
Okeoma OI, Adediran AO, Adeoti DO, Matthew CO. Cost-Effectiveness of Fixed-Dose Combination Polypills for Secondary Cardiovascular Disease Prevention: A Systematic Review. International Journal of Evidence-Based Medicine. 2026;1(3), jebm010. https://doi.org/10.63946/jebm/18966
Chicago
Okeoma, Obiageri Ihuarulam, Adetunji Olawale Adediran, David O. Adeoti, and Comfort Ohunene Matthew. "Cost-Effectiveness of Fixed-Dose Combination Polypills for Secondary Cardiovascular Disease Prevention: A Systematic Review". International Journal of Evidence-Based Medicine 2026 1 no. 3 (2026): jebm010. https://doi.org/10.63946/jebm/18966
MLA
Okeoma, Obiageri Ihuarulam et al. "Cost-Effectiveness of Fixed-Dose Combination Polypills for Secondary Cardiovascular Disease Prevention: A Systematic Review". International Journal of Evidence-Based Medicine, vol. 1, no. 3, 2026, jebm010. https://doi.org/10.63946/jebm/18966

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Supplementary File

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