Population Secondary prevention patients who have suffered a CHD event or a stroke (cohort weighted 57.9% post-CHD and 42.1% post-stroke)
Intervention Polypill strategy (ASA, atorvastatin, ramipril)
Comparators Same monocomponents administered concomitantlya
Model structure Markov model with 4 health states
  • Stable
  • Acute CHD
  • Acute stroke
  • Death state (CV death, non-CV death)
Annual cycles (except for the first year with 3-month cycle length)
Model setting Payer perspective of the Portuguese National Healthcare Service
Lifetime horizon
Discount rate (costs and health outcomes): 4%
CV risk equations SMART risk equations for recurrent CHD and stroke risk model (Dorreijstein et al[@161319]) for the base case
Framingham risk equations for the sensitivity analysis
  • D’Agostino et al[@161320] for subsequent CHD risk model
  • D’Agostino et al[@161321] for primary stroke risk model
Outcomes Health outcomes:
  • LY gained
  • QALY gained
  • No. of subsequent CV events, recurrent strokes, and CV deaths prevented by using the polypill strategy vs monocomponents
Cost outcomes: Total costs
Incremental results
  • ICER with polypill strategy vs monocomponents
  • ICUR with polypill strategy vs monocomponents