Cost-Effectiveness of the CNIC-Polypill Strategy Compared With Separate Monocomponents in Secondary Prevention of Cardiovascular and Cerebrovascular Disease in Portugal: The MERCURY Study

Background: Cardiovascular (CV) diseases remain a leading and costly cause of death globally. Patients with previous CV events are at high risk recurrence. Secondary prevention therapies improve factor control reduce disease costs. Objectives: To assess the cost-effectiveness polypill strategy (CNIC-Polypill) compared loose combination monocomponents to factors in patients coronary heart or stroke. Methods: A Markov model cost-utility analysis was developed using 4 health states, SMART equation, 3-month cycles for year 1 annual thereafter, over lifetime horizon from perspective National Health System Portugal (base case). The NEPTUNO study, Portuguese registries, mortality tables, official reports, literature were consulted define effectiveness, epidemiological costs, utility data. Outcomes costs (estimated 2020 euros) per life-year (LY) quality-adjusted LY (QALY) gained. 4% discount rate applied. Alternative scenarios one-way probabilistic sensitivity analyses tested consistency robustness results. Results: CNIC-Polypill secondary provides more QALY, higher cost, than monocomponents. incremental ratio is €1557/QALY Assuming willingness-to-pay threshold €30 000/QALY gained, there 79.7% 44.4% probability being cost-effective cost-saving, respectively, Results consistent alternative robust analyses. Discussion: reflects increments number years would live quality life CNIC-Polypill. clinical effectiveness initially demonstrated study has been recently corroborated SECURE trial. cost emerges slightly above comparator, but estimates indicate that consistently remains within acceptable affordability margins. Conclusion: strategy. In histories stroke, effectively controls