This is a story about a physician’s viewpoint on a speculative drug known as a “polypill” to battle “heart disease, diabetes and other illnesses all at the same time.” This pill would be used in a preventive way among all healthy adults older than 50.
While the notion is interesting–can a one-size-fits-all polypill help safely and effectively stave off common diseases of aging–the story didn’t include enough information for readers to understand the issue. Evidence-wise, we don’t get a sense of if there are any clinical trial results examining the benefits of using a polypill among a healthy population of older adults. Important trade-offs like side effects are dismissed, and there’s very little indication of if or when such a pill might be available to a general population.
This story contained opinions from the author, but wasn’t labeled as an opinion nor appeared in the opinion section–it ran in the health section.
The American population is aging, and the diseases targeted by the polypill are primarily found in older adults. A polypill used in a preventive manner could possibly delay the development of these problems, though it might also carry risks that outweigh these benefits.
There aren’t specifics on cost. The story states that the various individual medications that might go in a polypill are “cheap,” but we have no evidence that a combined pill would also be cheap. The story links to a “less comprehensive” polypill available online by prescription, but doesn’t tell us how much it costs.
The story says that these drugs in combined form would “battle heart disease, diabetes and other illnesses all at the same time,” but there is no quantification of how much they would help a healthy older adult.
The story doesn’t mention important harms of the various medications that might go into the pill. We’re told only that “the doses are low, so it’s relatively safe.” We wanted to see a nod to side effects, risks and trade-offs of using these drugs in a broad preventive manner. Taking a baby aspirin every day, for example, can increase the risk of serious gastrointestinal bleeding, which is why guidelines don’t recommend that everyone over 50 take them.
The story does state that a polypill might actually backfire by causing people to think it will protect them, and therefore they exercise less and eat worse.
There is no indication of what the evidence is for the use of such a drug by everyone older than 50, nor how high-or low-quality the evidence is.
The story is putting forth the idea that this type of drug might be a great idea to use in everyone older than 50. The suggestion that everyone needs a pill in the absence of any evidence, and that healthy older adults would benefit, is classic disease-mongering.
The story referred to two separate academic papers, but does not cite any researchers, nor any interviews with experts. The coverage would have been improved by seeking out and offering other opinions, rather than glossing over the concerns of critics with a two-sentence paraphrase of their arguments.
There is no comparison with other approaches, except the implication that behavioral approaches like exercise are not necessarily easily followed, and so taking a pill is an easier choice. Granted, when you depend on human compliance and behavior change for public health benefits, the results will be limited. But, the story overlooks the fact that taking a pill every day also requires long-term compliance, limiting the results, too.
This was a confusing point for us–the author mentions having two friends who appear to be self-medicating using several of the mentioned drugs, with the aim of preventing heart disease and diabetes. Then we’re told that a similar regimen could feasibly be rolled into a one-size-fits-all “polypill” for the general public, and the story speculates what that pill “might” contain.
The story then adds, as an aside, that there is a less comprehensive “polypill” available via online ordering, and provides a link to the site.
It’s not clear if or when a more comprehensive polypill for the masses might become available.
The story doesn’t make untoward claims of novelty and cites previous research on this concept, which provides context. The story could have alerted readers that the concept of a polypill for prevention goes back more than a decade.
The story doesn’t appear to rely on a news release, it appears to be original commentary.
Comments (2)
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Melinda Beck
June 20, 2016 at 9:01 amJust for the record, this ran in the WSJ’s Weekend Review section, which is entirely opinion and essays, not in the regular health section. It’s also clear from use of “I” throughout that it’s a first-person essay.
Kevin Lomangino
June 20, 2016 at 10:34 amThanks for the clarification of where this appeared, presumably in the print version. We found it online, as many other readers may have, listed under “health.”
It was not clear to us that this was part of the weekend review section composed entirely of opinion and essays.
Kevin Lomangino
Managing Editor
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