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The role of losartan in cost-effective hypertension control
H McIntyre1, F V Costa, R Düsing
1Conquest Hospital, East Sussex, Hastings, UK. hfmdoc@aol.com
Insights
Poor hypertension control is linked to patients not adhering to medication. Losartan, an angiotensin II antagonist, shows better patient adherence and cost-effectiveness compared to other antihypertensives.
Area of Science:
- Cardiovascular Medicine
- Pharmacoeconomics
Background:
- Hypertension control remains suboptimal in Europe and the USA, leading to significant morbidity, mortality, and healthcare costs.
- Patient non-adherence to prescribed therapy is a major contributor to poor hypertension management.
- Drug side-effects are a key driver of non-compliance, highlighting the need for well-tolerated antihypertensive agents.
Purpose of the Study:
- To evaluate the adherence and cost-effectiveness of antihypertensive therapies, focusing on the angiotensin II antagonist losartan.
- To compare the total cost of care associated with losartan versus older antihypertensive drugs, considering acquisition and accessory costs.
- To explore potential non-haemodynamic benefits of losartan that may influence overall cost-effectiveness.
Main Methods:
- Review of existing studies demonstrating patient adherence to losartan compared to other antihypertensives.
- Analysis of the cost implications of antihypertensive therapy, including drug acquisition, accessory costs, and costs associated with switching medications due to side-effects.
- Consideration of non-haemodynamic benefits, such as cognitive and renal protection, in the cost-effectiveness assessment.
Main Results:
- Studies indicate higher patient adherence rates with losartan compared to other antihypertensive medications.
- While losartan has higher acquisition costs, its total cost of care, including accessory costs, is comparable to older drugs like diuretics.
- Switching therapy due to side-effects incurs additional costs that favor well-tolerated agents like losartan.
Conclusions:
- Prescribing well-tolerated antihypertensives like losartan is crucial for improving patient adherence and achieving cost-effective hypertension management.
- The overall cost-effectiveness of losartan is favorable when considering adherence, accessory costs, and potential non-haemodynamic benefits.
- Further research is needed to fully elucidate the comprehensive cost-effectiveness of antihypertensive drugs, including losartan.
Abstract:
Despite recent guidelines emphasising the need for aggressive treatment in patients with elevated blood pressure, the control of hypertension in Europe and the USA is poor, imposing a considerable burden in terms of patient morbidity and mortality, and associated healthcare costs. A major factor contributing to the suboptimal control of hypertension is the failure of patients to adhere to their prescribed therapy. Drug side-effects are an important cause of non-compliance and prescribing a well-tolerated agent that promotes good compliance is therefore the key to the cost-effective management of hypertension. Several studies have demonstrated that patients are more likely to remain on therapy with the angiotensin II antagonist losartan than other antihypertensives. Although the acquisition costs of new antihypertensives such as losartan are greater than for older drugs, such costs represent only a small proportion of the total cost of prescribing antihypertensive therapy. When accessory costs are also considered, the total cost of care with newer antihypertensives is comparable with those for diuretics. The costs involved if therapy has to be switched due to unacceptable side-effects also need to be taken into account when assessing relative cost effectiveness. Furthermore, savings may accrue from the non-haemodynamic benefits of losartan, such as improved cognitive function and renal protection. Further studies will increase awareness of the true cost effectiveness of antihypertensive drugs.