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Health Check: 'The one problem with the polypill is that it doesn't exist'

Jeremy Laurance
Monday 07 July 2003 00:00 BST
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Every so often a paper appears in the medical journals that blows the socks off even hardened medical editors. It happened last week with the announcement of the "polypill", a combination of six medicines that, it is claimed, would be safe enough to give to every person over 55 and would cut heart attacks and strokes by more than 80 per cent. By any standards, that is a staggering claim. Heart disease is the biggest killer in the Western world and affects one out of every three people over 55. The British Medical Journal said it was possibly the most important paper it had published for 50 years.

But amid the excitement one small problem with the polypill has escaped attention. It does not exist. It is only an idea - an ingenious one, but an idea none the less. Its inventor, Professor Nick Wald of University College, London, has had the idea for some time. Three years ago he took the idea to Glaxo in the hope that the multinational drug company would turn it into reality.

But Glaxo turned him down because patenting a combination of drugs is regarded as impossible unless it can be shown that the combination has an effect different from the sum of its components. The whole point of the polypill is that it is not a new agent, but one based on tried-and-tested medicines - aspirin, a cholesterol-lowering statin, folic acid and three blood pressure agents in half doses - which are known to be safe, effective and cheap.

The next port of call was the British Medical Association, owners of the BMJ, which was asked to invest £5m in the venture. It too turned the request down. So Professor Wald and his colleagues are left with an idea seeking a sponsor. The problem is that trials of the polypill would need to be carried out before it could obtain a licence. But without a patent, once it was licensed, anyone could make it. So who is going to fund the trials?

The obvious answer is a government body such as the Medical Research Council. Failing that, a charity such as the British Heart Foundation might be prevailed upon, though their initial response to last week's announcement was carping. "A polypill should never be a license for people to lead unhealthy lifestyles," said Sir Charles George, the medical director.

Last week Sir Liam Donaldson, the Government's chief medical officer, proposed five measures to improve the health of the population, including a ban on smoking in public. If the polypill lived up to its promise it would do more than all five measures combined - and more, probably, than all the recommendations of Government chief medical officers for the last 50 years. The polypill deserves funding. Step forward Bill Gates...

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