Polypills

According to Thomas Edison (1847–1931): ‘The doctor of the future will give no medication but will interest his patients in the care of the human frame, diet and in the cause and prevention of disease’ (Anonymous, 2025). Notwithstanding Edison's achievements as an inventor, a gift for clairvoyance eluded him, since his prediction has not yet been realised.

For example, in their review and meta-analysis, Delara et al (2022) reported that the ‘pooled estimated prevalence of polypharmacy in the 54 studies reporting on polypharmacy in all medication classes was 37%.’ And Bennie et al (2024) note that ‘[t]he prevalence of polypharmacy of 5–9 drugs was 22.8% (UK) to 58.3% (Germany); ≥10 drugs from 11.3% (UK) to 28.5% (Germany).’

Yet despite this dependence on medication, might the era of polypharmacy be supplanted with what we might term ‘monopharmacy’? It's a question that warrants reflection in the light of increasing attention being given to the apparent virtues of the so-called polypill, a word first coined by Wald and Law (2003). They estimated that the combination of six ingredients: namely, a statin like atorvastatin or simvastatin; three blood pressure lowering drugs; folic acid; and aspirin ‘reduces ischaemic heart disease events by 88% … and stroke by 80% …’ (Wald and Law, 2003).