Cost-effectiveness of the CV-polypill strategy versus standard care for secondary cardiovascular prevention in Spain: an analysis based on the SECURE trial

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...

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Autores: Gaziano, T, Castellano, JM, Dymond, A, Looby, A, Mealing, S, Owen, R, Pocock, S, González-Juanatey, JR, Cordero, A, Fernández-Ortiz, A, Linhart, A, Schiele, F, Doehner, W, Fernández, LO, Fuster, V
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2025
País:España
Institución:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
Repositorio:r-FISABIO. Repositorio Institucional de Producción Científica
OAI Identifier:oai:fisabio.fundanetsuite.com:p19245
Acceso en línea:https://fisabio.portalinvestigacion.com/publicaciones/19245
Access Level:acceso abierto
Palabra clave:Cost-effectiveness analysis
Cardiovascular prevention
CV-Polypill
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spelling Cost-effectiveness of the CV-polypill strategy versus standard care for secondary cardiovascular prevention in Spain: an analysis based on the SECURE trialGaziano, TCastellano, JMDymond, ALooby, AMealing, SOwen, RPocock, SGonzález-Juanatey, JRCordero, AFernández-Ortiz, ALinhart, ASchiele, FDoehner, WFernández, LOFuster, VCost-effectiveness analysisCardiovascular preventionCV-PolypillBackground 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 <euro>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.ELSEVIER2025info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersionhttps://fisabio.portalinvestigacion.com/publicaciones/19245Lancet Regional Health-EuropeISSN: 26667762reponame:r-FISABIO. Repositorio Institucional de Producción Científicainstname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)Inglésinfo:eu-repo/semantics/openAccessoai:fisabio.fundanetsuite.com:p192452026-06-11T12:45:17Z
dc.title.none.fl_str_mv Cost-effectiveness of the CV-polypill strategy versus standard care for secondary cardiovascular prevention in Spain: an analysis based on the SECURE trial
title Cost-effectiveness of the CV-polypill strategy versus standard care for secondary cardiovascular prevention in Spain: an analysis based on the SECURE trial
spellingShingle Cost-effectiveness of the CV-polypill strategy versus standard care for secondary cardiovascular prevention in Spain: an analysis based on the SECURE trial
Gaziano, T
Cost-effectiveness analysis
Cardiovascular prevention
CV-Polypill
title_short Cost-effectiveness of the CV-polypill strategy versus standard care for secondary cardiovascular prevention in Spain: an analysis based on the SECURE trial
title_full Cost-effectiveness of the CV-polypill strategy versus standard care for secondary cardiovascular prevention in Spain: an analysis based on the SECURE trial
title_fullStr Cost-effectiveness of the CV-polypill strategy versus standard care for secondary cardiovascular prevention in Spain: an analysis based on the SECURE trial
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 trial
title_sort Cost-effectiveness of the CV-polypill strategy versus standard care for secondary cardiovascular prevention in Spain: an analysis based on the SECURE trial
dc.creator.none.fl_str_mv Gaziano, T
Castellano, JM
Dymond, A
Looby, A
Mealing, S
Owen, R
Pocock, S
González-Juanatey, JR
Cordero, A
Fernández-Ortiz, A
Linhart, A
Schiele, F
Doehner, W
Fernández, LO
Fuster, V
author Gaziano, T
author_facet Gaziano, T
Castellano, JM
Dymond, A
Looby, A
Mealing, S
Owen, R
Pocock, S
González-Juanatey, JR
Cordero, A
Fernández-Ortiz, A
Linhart, A
Schiele, F
Doehner, W
Fernández, LO
Fuster, V
author_role author
author2 Castellano, JM
Dymond, A
Looby, A
Mealing, S
Owen, R
Pocock, S
González-Juanatey, JR
Cordero, A
Fernández-Ortiz, A
Linhart, A
Schiele, F
Doehner, W
Fernández, LO
Fuster, V
author2_role author
author
author
author
author
author
author
author
author
author
author
author
author
author
dc.subject.none.fl_str_mv Cost-effectiveness analysis
Cardiovascular prevention
CV-Polypill
topic Cost-effectiveness analysis
Cardiovascular prevention
CV-Polypill
description 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 <euro>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.
publishDate 2025
dc.date.none.fl_str_mv 2025
dc.type.none.fl_str_mv info:eu-repo/semantics/article
info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.none.fl_str_mv https://fisabio.portalinvestigacion.com/publicaciones/19245
url https://fisabio.portalinvestigacion.com/publicaciones/19245
dc.language.none.fl_str_mv Inglés
language_invalid_str_mv Inglés
dc.rights.none.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.publisher.none.fl_str_mv ELSEVIER
publisher.none.fl_str_mv ELSEVIER
dc.source.none.fl_str_mv Lancet Regional Health-Europe
ISSN: 26667762
reponame:r-FISABIO. Repositorio Institucional de Producción Científica
instname:Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
instname_str Fundación para el Fomento de la Investigación Sanitaria y Biomédica de la Comunitat Valenciana (FISABIO)
reponame_str r-FISABIO. Repositorio Institucional de Producción Científica
collection r-FISABIO. Repositorio Institucional de Producción Científica
repository.name.fl_str_mv
repository.mail.fl_str_mv
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