Heart attacks and strokes are among the leading causes of death globally, with millions suffering from cardiovascular diseases (CVD) every year. There are more than seven million people in the UK alone, with about 100,000 patients experiencing heart attacks annually. However, a group of researchers at University College London (UCL) estimate that one 'polypill' taken daily day could eliminate a majority of these cases dramatically lowering death tolls.

The proposed polypill, a combination of a statin and three blood pressure-lowering drugs, has been under study for over two decades. Experts argue that introducing this pill universally for individuals aged 50 and above could be more effective than the current NHS Health Check, which assesses risk factors every five years for those aged between 40 and 74.

Studies have repeatedly proven the effectiveness of the polypill in preventing CVD. A groundbreaking 2019 study in The Lancet found that five years' use of the polypill cut the risk of heart attack and stroke by a third. In addition, previous modelling analyses have estimated that if given universally to people over 55, the polypill might be able to prevent 80% of heart attacks and strokes.

Today, the NHS Health Check follows a risk-based model in which patients are tested for CVD risk factors and treated with drugs accordingly. Yet, as per UCL's study, this system has serious flaws:

Low Uptake: Just 40% of those eligible for the NHS Health Check choose to have it, leaving a considerable number of at-risk patients undiagnosed and untreated.

Ineffective Prediction of Risk: The majority of heart attacks and strokes happen to people at average risk levels, thus making it challenging to identify the need for intervention effectively.

Limited Effectiveness: Even at maximum take-up, the NHS Health Check programme is predicted to have fewer health impacts compared to a polypill initiative applied to the whole population.

Simplicity and Affordability of the Polypill Strategy

One of the big benefits of the polypill is that it is so easy. In contrast to the existing screening-based model, the polypill scheme would not involve complicated medical tests or lengthy risk assessments. Instead, people reaching 50 would just have to fill out a few questions to determine possible side effects before they were prescribed.

Professor Aroon Hingorani of the UCL Institute of Cardiovascular Science, one of the strongest proponents of this scheme, says:

"Finally, the time is now to do much better on prevention. A population approach would prevent a lot more heart attacks and strokes than is done today with a strategy of trying to target a smaller group only."

Aside from the possible health implications, the polypill is also an economic solution. The drugs used are off-patent, thus cheap to produce and distribute. With the vast economic cost of managing CVD-related illnesses, a preventive model could result in substantial cost-saving for the NHS in the future.

The polypill has been proven to be effective by numerous international trials. In 2019, a randomised trial in rural Iran discovered that participants who took the polypill for five years had a 34% reduced risk of having a heart attack or stroke compared to non-participants.

Likewise, modelling research has indicated that even if only 8% of people aged over 50 took up the polypill regimen, it would still be more beneficial to their health than the NHS Health Check programme.

Is This a Case of Over-Medicalisation?

One of the main objections to the polypill strategy is the suggestion that it might result in the unnecessary medicalisation of a significant proportion of the population. But, it is argued, it should be considered as a preventative measure, not as mass medication.

Professor Sir Nicholas Wald of UCL's Institute of Health Informatics explains:

"Instead of being a 'medicalisation' of a significant proportion of the population, a polypill programme is a prevention measure to prevent an individual from becoming a patient."

He compares it with public health measures like water fluoridation or compulsory seatbelts—interventions that have been shown to have a significant impact in reducing public health danger at low individual cost.

With the evidence in favour of the polypill's effectiveness and viability overwhelming, experts are calling on the NHS to act now. It is their belief that substituting the NHS Health Check with a polypill-based prevention program could be the UK government's flagship policy under its pledge to put disease prevention ahead of cure.

As Professor Hingorani points out, "The status quo is not a justifiable option." With CVD still a major cause of death globally, taking a population-wide polypill approach could be a turning point for preventative medicine, potentially saving thousands of lives annually. The question now is whether the NHS will take up this call and establish a policy with the potential to transform the prevention of cardiovascular disease on a national level.

More than 20 vials of compounded tirzepatide, a GLP-1 medication containing the same active ingredient as Eli Lilly’s Mounjaro and Zepbound, have been recalled in the US over sterility concerns, according to the Food and Drug Administration (FDA).

The recall, issued by Apothecary Pharma, also includes a vial of NAD+ injection.

The FDA classified the recall as Class II, meaning the affected products could cause temporary or medically reversible adverse health consequences, while the likelihood of serious harm is considered low.

The recall follows a December 2025 FDA warning letter to Apothecary Pharma, which cited serious deficiencies in the North Carolina company’s sterile drug production practices.

The recalled injections are compounded versions of tirzepatide. Unlike FDA-approved, brand-name medications, compounded drugs are custom-prepared by pharmacies to meet specific patient needs.

Which Compounded GLP-1 Injections Were Recalled?

Also read: US FDA May Allow Pharmacies To Make Unapproved Peptide Injections: What Are the Safety Concerns?

The affected tirzepatide product is a prescription injection with a concentration of 18 mg/mL, supplied in a 4 mL multidose vial. Its National Drug Code (NDC) number is 85091-001-18.

The recalled lot numbers are AP-202622 through AP-202625 and AP-202627 through AP-202644. The products have beyond-use dates ranging from October 7 to November 26, 2026.

The recall also includes one vial of NAD+ injection.

What Should You Do If You Have a Recalled Vial?

The FDA and Apothecary Pharma have not issued a public statement clarifying what patients should do with the affected vials. Some customers have reported receiving requests through their prescribers to return or dispose of the products or contact the manufacturer directly.

NewLife Rx, a pharmaceutical fulfillment service that distributed some of the recalled vials, reportedly told certain customers that Apothecary had described the recall as a documentation issue.

According to a notice reviewed by USA TODAY, the recall was conducted at the retail level and did not extend to patients or require them to stop using or return their medications.

However, neither the FDA nor Apothecary Pharma has publicly clarified the reason for the recall or the safety of the affected products.

Although a Class II classification indicates a relatively low likelihood of serious harm, it does not mean a product is entirely risk-free.

If you have an affected lot, consult your prescriber or healthcare provider before using it again and follow their instructions.

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What Are the Risks of Compounded GLP-1 Drugs?

A compounded drug is a medication prepared by a compounding pharmacy to meet an individual patient's specific medical needs. This may include removing an allergen, adjusting a dosage, or preparing a formulation that is not commercially available.

While these medications can serve specific medical needs, they are not FDA-approved in the same way as branded drugs. The FDA does not review compounded formulations for safety, effectiveness, and quality before they are marketed.

Demand for GLP-1 medications for weight loss skyrocketed worldwide between 2022 and 2025, leading to shortages of semaglutide and tirzepatide.

During these shortages, compounding pharmacies were legally allowed under specific circumstances to prepare several versions of these medications.

Many patients turned to compounded GLP-1s because they were often affordable, available, and easier to buy online.

Potential risks of compounded GLP-1 drugs include:

• Inaccurate Dosing
• Sterility Concerns
• Different Ingredients
• Limited Safety Data
• Counterfeit or Unregulated Products

The US Food and Drug Administration (FDA) has approved Hibsago (bepirovirsen), a first-of-its kind treatment for certain adults with chronic hepatitis B. The drug controlled virus activity in some patients after stopping all treatment.

Announced on October 20, 2026, the approval makes Hibsago the first FDA-approved antisense oligonucleotide for chronic hepatitis B.

It is approved for certain adults without cirrhosis who have already been taking antiviral medication for at least six months, have suppressed levels of hepatitis B virus (HBV) and meet specific criteria for hepatitis B surface antigen (HBsAg).

In clinical trials, 19% of patients receiving Hibsago maintained viral control 24 weeks after stopping all hepatitis B treatment. No amount of HBsAg was detected in their blood. The treatment is meant to offer an alternative for some patients who otherwise need long-term antiviral medication.

“For many people living with chronic hepatitis B, treatment can mean taking antiviral medication for years to keep the virus suppressed,” said Wendy Carter, DO, acting director of the Office of Infectious Diseases in the FDA’s Center for Drug Evaluation and Research.

“Hibsago provides a new treatment approach that gives some patients the possibility of maintaining control of the virus after all chronic HBV treatment has ended. This approval represents an important advance for people living with this serious disease.”

How Does Hibsago Work?

Hibsago targets the genetic aspects the hepatitis B virus targets. By reducing viral RNA and hepatitis B surface antigen, the drug helps the immune system control the infection even after after treatment ends.

The drug is administered as an injection under the skin for up to 24 weeks, alongside a patient's existing hepatitis B medication. Patients continue their treatment for at least 24 weeks after the final Hibsago injection. They can then stop all treatment if they meet specified clinical and laboratory criteria.

The FDA also authorised a diagnostic test to help identify eligible patients and monitor them during treatment.

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What Did The Clinical Trials Find?

The approval was supported by two Phase 3 trials, B-Well 1 and B-Well 2, which compared Hibsago with a placebo in adults receiving established antiviral treatment.

Across the trials, 24% of patients receiving Hibsago met the criteria to stop their existing antiviral medication, compared to none in the placebo groups.

At 24 weeks after stopping all treatment, 19% of patients receiving Hibsago maintained viral control. Hepatitis B surface antigen was also no longer detectable in their blood.

The outcome means the virus remains controlled without ongoing treatment according to specified laboratory criteria.

Also read: H. pylori, HPV Among Five Infections Behind 1 In 8 Cancers Worldwide: Lancet

What Are The Risks?

Hibsago carries a warning for serious liver reactions and thrombocytopenia, or low platelet counts, which can increase the risk of life-threatening bleeding.

Other warnings include poor kidney function and inflammatory reactions like vasculitis. Patients require regular blood tests and medical monitoring before and during treatment.

The FDA granted Hibsago Fast Track and Breakthrough Therapy designations, along with Priority Review. The drug was approved for GSK plc.

The treatment is not suitable for everyone with chronic hepatitis B. Eligibility depends on liver health, existing treatment, viral suppression and laboratory results.

Chronic hepatitis B infections among children and young adults in the United States could rise by 83% if the country moves away from routinely recommending vaccination at birth for all newborns, according to a new study titled Projected Effect of 2026 Federal Changes to the Childhood Immunization Schedule on Chronic Hepatitis B Virus Infections in the United States, published in Annals of Internal Medicine recently.

Researchers from Massachusetts General Hospital and Harvard Medical School analysed outcomes for a birth cohort of 3.6 million infants over their first 20 years.

The study examined the impact of changes to US hepatitis B vaccine recommendations for babies born to mothers who test negative for the virus.

Under the revised approach, parents and healthcare providers decide together whether and when to begin vaccination. The findings suggest that this could leave more children vulnerable to infection, increasing the cases of chronic hepatitis B.

What Did The Study Find?

The model compared universal vaccination at birth with two alternatives. The first is delaying the first dose until at least two months of age, and the second is leaving the decision to parents and healthcare providers.

Researchers estimated that delaying vaccination could increase chronic hepatitis B infections acquired by age 20 by 19%. Under the second option, the estimated increase was 83%.

The model estimated 255 chronic infections under universal birth-dose vaccination, compared to 303 if vaccination was delayed and 467 under shared decision-making.

The number of people who remained at high risk to hepatitis B at age 20 was also projected to increase. Under universal vaccination at birth, around 232,000 people in the cohort would remain at risk. This rose to 474,000 with delayed vaccination and approximately 1.8 million under shared decision-making.

Study's corresponding author Amir Mohareb said, “These findings show why policy makers should re-implement recommendations for universal hepatitis B vaccination at birth.”

Also read: Hepatitis C: Could 8-Week Treatment Help India Reach More Patients?

Importance Of Hepatitis B Birth Dose

Hepatitis B is a viral infection that affects the liver and spreads through infected blood and certain bodily fluids, including during childbirth. Infection acquired during infancy is likely to become chronic, leading to cirrhosis, liver failure or liver cancer in the future.

The universal hepatitis B birth-dose recommendation was introduced in the US in 1991. The first dose provides early protection, including when maternal infection is missed or a child's exposure risk is not recognised.

In December 2025, the US Advisory Committee on Immunization Practices recommended replacing universal vaccination at birth with shared decision-making for infants whose mothers test negative.

The Centers for Disease Control and Prevention adopted this approach in January 2026. Babies born to mothers who test positive or whose infection status is unknown continue to be recommended to receive the birth dose promptly, along with hepatitis B immune globulin when indicated.

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Increase In Infections, Deaths And Costs

The changes in vaccine policy is also likely to lead to hundreds more infections, deaths, and millions of dollars in higher costs, according to another research published in JAMA Pediatrics.

Pediatricians, public health experts, and dozens of medical groups warned that it could harm children and their families. So the JAMA studies modelled the potential impact of the policy.

The first study estimated that delaying the first hepatitis B vaccine dose by two months for babies born in a single year to mothers who tested negative — about 80 percent of the 3.6 million US births annually — would increase lifetime health-care costs by at least $16 million, The Washington Post reported. If vaccination were delayed by seven months, it would cost an additional $19.8 million.

The second study modeled what would happen if only 10 per cent of babies born to unscreened mothers received a birth dose; an additional 628 babies would get infected.

“One of the most concerning implications is how many more infected Hep B babies will we see,” said co-author Rachel Epstein, a pediatric and adult infectious diseases clinician at Boston Medical Center.

“A universal birth dose helps prevent a substantial number of infections in babies of a lifelong condition that we do not have a cure for,” she added.