Evidence mapPaperPMID 40678039Full record

ArticleThe Lancet regional health. Europe2025

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

Thomas Gaziano, José María Castellano, Amy Dymond, Alissa Looby, Stuart Mealing, Ruth Owen, Stuart Pocock, José Ramón González-Juanatey, Alberto Cordero, Antonio Fernández-Ortiz and 5 more

Registry-linked trialAbstract read
In one paragraph

Article in The Lancet regional health. Europe, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02596126 (Secondary Prevention of Cardiovascular Disease in the Elderly Trial), which is not on this map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02596126 phase3completednot on this map

Secondary Prevention of Cardiovascular Disease in the Elderly Trial

TypeinterventionalSponsorFundación Centro Nacional de Investigaciones Cardiovasculares Carlos IIIRan2016 to 2022Enrolled2,499ConditionsMyocardial Infarction, Cardiovascular DiseaseArmsCardiovascular Polypill, Treatment Prevention for Secondary CV
3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

15 authors.

Thomas GazianoBrigham and Women's Hospital, Harvard Medical School, Boston, MA, USA.
José María CastellanoCentro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.
Amy DymondYork Health Economics Consortium (YHEC), York, United Kingdom.
Alissa LoobyYork Health Economics Consortium (YHEC), York, United Kingdom.
Stuart MealingYork Health Economics Consortium (YHEC), York, United Kingdom.
Ruth OwenCentro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.
Stuart PocockCentro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.
José Ramón González-JuanateyHospital Clínico Universitario de Santiago de Compostela, IDIS, CIBERCV, Santiago de Compostela, Spain.
Alberto CorderoCardiology Department, Hospital Universitario de San Juan, Alicante, Spain.
Antonio Fernández-OrtizHospital Clinico San Carlos, Idissc, Universidad Complutense, Madrid, Spain.
Aleš LinhartVšeobecná Fakultní Nemocnice v Praze, Prague, Czech Republic.
François SchieleCentre Hospitalier Régional Universitaire de Besançon - Hôpital Jean Minjoz, University of Franche Comte SINERGIES, Besancon, France.
Wolfram DoehnerBerlin Institute of Health Center for Regenerative Therapies, Charité - Universitätsmedizin Berlin, Berlin, Germany.
Luisa Ojeda FernándezLaboratory of Cardiovascular Prevention, Istituto di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy.
Valentín FusterCentro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

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.

Indexed as

Cardiovascular preventionCost-effectiveness analysisCV-Polypill

Identifiers

PMID40678039
PMCPMC12269512

What Socratic holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.