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Controlling the rising costs of cardiovascular care
Date:1/24/2011

Canada's health care system could have saved $77 million in 2006 if it had adopted a more restrictive policy on the cardiovascular drugs angiotensin receptor blockers without a negative impact on cardiovascular health, according to a study published in CMAJ (Canadian Medical Association Journal) (pre-embargo link only) http://www.cmaj.ca/embargo/cmaj100787.pdf.

Cardiovascular drug costs in Canada increased by more than 200% from 1996 to 2006. In particular, the use of angiotensin-receptor blockers rose by 4000% during the same time, although the benefits of these medications over angiotensin-converting-enzyme (ACE) inhibitors has not been proven other than a reduction in dry cough, a benign and reversible side effect.

Angiotensin-receptor blockers have been shown to reduce deaths from hypertension in one study. However, other studies including several randomized controlled trials, did not show angiotensin-receptor blockers to be more effective than ACE inhibitors when treating hypertension, heart failure, or the secondary prevention of coronary artery disease.

The study, an economic analysis of health care costs in two scenarios, found that Canada could have saved $77.1 million, likely without negative effects on health, if the country had a policy restricting access to angiotensin-receptor blockers. Unfortunately, British Columbia is currently the only province in Canada with a restrictive policy on angiotensin receptor blockers.

Administrators of drug benefit plans need to consider carefully the restriction of specific drugs, let alone an entire class, especially in the absence of an effective alternative," writes Dr. Stphane Rinfret, Multidisciplinary Cardiology Department, Quebec Heart and Lung Institute (Institut universitaire de cardiologie et de pneumologie de Qubec) with coauthors. They cite the example of restrictions on clopidogrel that resulted in underuse o
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Contact: Kim Barnhardt
kim.barnhardt@cmaj.ca
613-520-7116 x2224
Canadian Medical Association Journal
Source:Eurekalert

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