Government body refuses to pay for $2m 'polypill' trial

By SIMON COLLINS

Government funders have refused to pay for a proposed $2 million trial of the controversial "polypill" in New Zealand.

The Auckland Clinical Trials Research Unit, which is organising the trial, will now run only a small pilot experiment using the pill on 200 people at high risk of heart attacks or strokes in Auckland, the Waikato and Wellington in the next few months.

The organising centre for the larger trial of 3000 people will move to the United States.

New Zealand's Health Research Council will fund the initial experiment through its ongoing programme support of the clinical trials unit, which has discretion over how it spends that part of its budget.

But the council has refused to fund the larger trial because its Government grant allowed it to fund only 23 per cent of the 199 health research applications it received last year.

Clinical trials unit director Dr Anthony Rodgers said the decision exposed a gap in the council's funding policy. "We [taxpayers] spend hundreds of millions a year on cardiovascular disease, and this could save large amounts of money," he said.

"There is a real gap in HRC funding to get behind things that will save the country money."

Dr Rodgers has been a long-time advocate of the polypill - the idea of combining several existing medications to reduce blood pressure, cholesterol and other risk factors for heart disease and stroke into one pill.

Two British researchers said last year that giving the combined pill to everyone over the age of 55 would cut the risk of heart attacks 88 per cent and strokes 80 per cent, extending people's lives without these diseases by up to 11 years.

Dr Rodgers said the polypill would be much cheaper than the individual existing drugs because it could be made in Asia from "generic" drugs whose patents had expired.

But he said neither the Ministry of Health nor district health boards allocated money to trials that could save lives.

They left research funding to the HRC. But it funded little clinical research, and had only four funding committees covering basic biomedical research, public health, and research involving Maori and Pacific people.

"Clinical research has to go to either the biomedical or the public health committee. It falls between the cracks," he said.

Speaking from Sydney, where he has been organising Australian participation in the polypill trials, Dr Rodgers said he was now targeting the US National Institutes of Health to pick up the main cost of the trial.

"We'll go back to the HRC this year, but most of our effort is going to concentrate on the US," he said.

"It would have been nice if it could have happened in New Zealand, but the idea of getting it out and tested on patient welfare is the most important thing."

Running the trial exclusively in the US would mean slower uptake of the pill in New Zealand, he said, because of scepticism that it would work here.

Dr Rodgers is urging the Government to help fund clinical trials through a policy such as Australia's "Start" scheme, which provides grants of up to half the cost of R&D projects.

"It's really a case of walking the walk.

"If one wants to move from a primary production economy to a knowledge-based economy, you do have to invest in research."

Polypill pros & cons

The polypill will combine drugs now used to lower blood pressure and cholesterol and to thin the blood.

A single pill will reduce the risks of heart attacks and strokes.

Supporters say it will be cheaper and more convenient than the individual drugs and will cut the risk of heart attacks more than 80 per cent.

Critics say people need personalised sets of drugs and health advice tailored to their needs, and that some will suffer side-effects from a polypill.