ARB switching strategy may not result in long-term savings within a five-year model, says Merck & Co

A study sponsored by the UK unit of US drug major Merck & Co shows that current budgetary pressures to switch patients to the cheapest available blood pressure drug may not result in long-term savings.

Published in the journal Current Medical Research, the study by Jonathan Belsey found that once patent expiry is taken into account, his projected five-year model suggests that maintaining or switching patients to Merck's Cozaar/Hyzaar (losartan) would yield considerably greater savings over five years.

For both undiscounted and discounted models, a losartan-based regimen represents the least costly option of the four agents tested. Median discounted expenditure per patient for each agent was: losartan: L506 ($1,009) versus L610 for AstraZeneca's Atacand (candesartan), L809 for Novartis' Diovan (valsartan) and L696 for Sanofi-Aventis and Bristol-Myers Squibb's Aprovel (irbesartan). The study also found that therapeutic switching can itself involve financial costs by aggravating patients and affecting adherence, as well as taking up the physician's time.