Can we create customized polypills for personalized drug formulation?

The concept of polypills has existed for decades. A polypill is a fixed-dose combination of multiple drugs designed to target specific health conditions. One of the most well-known examples is the cardiovascular polypill, which combines blood pressure-lowering agents, statins, and antiplatelet drugs to prevent heart attacks and strokes [Citation1]. The synergistic effects of these active pharmaceutical ingredients (APIs) have been shown in multiple randomized controlled trials to significantly reduce cardiovascular risk factors and events while minimizing side effects [Citation2].

Personalized polypills take this concept a step further by tailoring both drug combinations and dosages to individual patients. Why is this necessary? Traditional ‘one-size-fits-all’ drug formulations fail to account for genetic variations, leading to suboptimal efficacy and a higher risk of side effects. A pharmacogenomics report by the Royal College of Physicians and the British Pharmacological Society found that 99.5% of people have at least one genetic variant affecting drug response, with 25% carrying four or more [Citation3]. This means that polypills with fixed-dose combinations may not provide optimal therapeutic benefits for every patient.

Additionally, the rising prevalence of multimorbidity, affecting 37.2% of adults globally and up to 67% of those over 74 [Citation4,Citation5], poses a major global health challenge. Patients with multiple chronic conditions often face complex medication regimens, leading to poor patient compliance and diminished quality of life. Alarmingly, 65% of older adults with multimorbidity do not adhere to their prescribed medications [Citation6]. This highlights the urgent need for solutions to reduce pill burden, such as personalized polypills, which could simplify treatment regimens and improve treatment outcomes.