The role of Losartan in cost-effective hypertension control

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 11 antagonist iosartan than other antihypertensives. Although the acquisition costs of new anti hypertensives such as iosartan are greater than for older drugs, such costs represent only a small proportion of the total cost of prescribing anti hypertensive therapy. When accessory costs are also considered, the total cost of care with newer anti hypertensives 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 iosartan, such as improved cognitive function and renal protection. Further studies will increase awareness of the true cost-effectiveness of anti hypertensive drugs.