UK's NICE calls for beta blocker phase out

The National Institute for Health and Clinical Excellence (NICE), which gives guidance for the use of medicines and therapies in the National Health Service for England and Wales, has said that beta blockers should no longer be used routinely for the treatment of hypertension, advising instead that patients should be prescribed a combination of drugs such as calcium channel blockers, angiotensin-converting enzyme inhibitors and diuretics.

This came as a surprise to many, since beta blockers are among the older and, as a result, cheapest drugs to treat hypertension, and the NICE has nearly always come out against more expensive therapies where the less so are still effective. In this evaluation, the agency argues that, in head-to-head trials, beta blockers were usually less effective than a comparator drug in reducing major cardiovascular events, particularly stroke. They were also less effective that ACE inhibitors or a calcium channel blocker at reducing the risk of diabetes, particularly in patients taking a beta blocker and a thiazide-type diuretic. The NICE concludes that, while these are more expensive initially, the proposed treatment regimens would lead to long-term cost savings.

Quoted by UK's The Times newspaper (on-line), Bryan Williams, professor of medicine at the University Hospitals of Leicester NHS Trust and a member of the guideline development group, has said that the cost of implementing the changes would be about L58.0 million ($105.5 million), with later cost-savings estimated at around L250.0 million.