Medical and cost-economy aspects of modern antihypertensive therapy--with special reference to 2 years of clinical experience with losartan.
Health economy is often addressed in terms of acquisition cost, i.e. the cost of the pill. For various reasons, mainly the stricter demands from drug regulatory agencies (increased development costs), novel agents must be expected to be more expensive than older drugs. However, if the costs of changing therapy and the costs induced by side effects and extra clinic visits are considered, the economic aspects become less of a consideration. If compliance is enhanced and better blood pressure control is achieved with the newer agents, then the therapeutic gains must be weighed against the economic aspects. Losartan, the first agent of the new class of angiotensin II receptor antagonists of the AT1 type, has been available for clinical use for more than 2 years. Losartan has proven antihypertensive effects and its safety profile in the initial controlled trials (approximately 2900 patients) and in general practice (more than 14,000 patients in Sweden) has been very good. Its effect on long-term morbidity and mortality has not yet been established but a large mortality endpoint trial is underway in hypertensive patients with cardiac hypertrophy (the LIFE trial). In heart failure, losartan has been shown to reduce 3-month mortality (the ELITE trial). Although it is too early to assess the full therapeutic benefit of losartan in relation to the total patient costs, its efficacy and low incidence of side effects has made it a useful new therapy for the treatment of hypertension.
Hansson
L
L
Department of Geriatries, University of Uppsala, Sweden.
D000959:Antihypertensive Agents / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use; D001713:Biphenyl Compounds / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use; D002986:Clinical Trials as Topic; D003362:Cost-Benefit Analysis; D006801:Humans; D006973:Hypertension / Q000188:drug therapy / Q000191:economics*; D007093:Imidazoles / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use; D019808:Losartan; D013777:Tetrazoles / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use
D000959:Antihypertensive Agents; D001713:Biphenyl Compounds; D007093:Imidazoles; D013777:Tetrazoles; D019808:Losartan