Cost of end-stage renal disease reduced by losartan – new study
October 30, 2001 | 12:00am
Losartan Improves Lives of Hypertensive Patients with Type 2 Diabetes and Kidney Disease by Reducing Need for Costly Dialysis and Transplantation Procedures, Resulting in Substantial Cost Savings
New data from the landmark RENAAL (Reduction of Endpoints in Non-Insulin Dependent Diabetes Mellitus with the Angiotensin II Antagonist Losartan) study show that treatment with the antihypertensive losartan not only helps hypertensive patients with Type 2 diabetes and kidney disease by protecting their kidneys, but also benefits society by providing an important cost savings. The analysis found that the United States health care system alone could save more than $3 billion USD (€3.3 billion) over 3.5 years, increasing to more than $4 billion USD (€4.7 billion) over four years, by treating these patients with losartan. The new data was recently presented at the American Society of Nephrology/International Society of Nephrology World Congress in San Francisco, California, USA.
Results from RENAAL indicated that treatment with losartan can effectively protect the kidney and reduce the risk of developing end-stage renal disease (ESRD) in hypertensive patients with Type 2 diabetes and kidney disease. ESRD is a serious and costly condition in which dialysis or transplantation is required for survival. Losartan is already the number two branded antihypertensive worldwide, and is the leading and most prescribed agent in the newest class of highly effective and well-tolerated antihypertensives known as angiotensin II antagonists (AIIA).
"The economic evaluation of the RENAAL study found that treatment with losartan not only reduces the risk of ESRD, but also could result in substantial cost savings," said William H. Herman, M.D., M.P.H. Professor of Internal Medicine and Epidemiology, University of Michigan, Ann Arbor, Michigan, United States, and lead author of the analysis. "These findings are particularly important, given the number of cases of ESRD that are presently challenging our health care system, combined with both the current shortages of nursing and technical staff needed for dialysis and the projected future shortage of nephrologists."
An economic evaluation of the RENAAL study, which was conducted in the United States, showed that losartan dramatically reduced the number of days that patients spent with ESRD (defined as initiation of dialysis or transplantation). Over 3.5 years, treatment with losartan resulted in 33.6 fewer days per patient with ESRD, and 46.9 fewer days per patient over four years. This reduction in ESRD days produced a $5,152 USD (€5,658) savings in ESRD-related costs per treated patient, p=0.004, over 3.5 years. This saving increased to $7,191 USD (€7,897) at four years.
When extrapolating these findings to the estimated 595,000 Type 2 diabetic patients with proteinuria (protein in the urine) in the United States, treatment with losartan would result in the following:
• Prevention of 36,500 ESRD cases over 3.5 years, or 46,000 cases over four years;
• Avoidance of an estimated 55,000 patient years of ESRD over 3.5 years, or 76,500 patient years of ESRD over four years;
• Savings of approximately $3.1 billion USD (€3.3 billion) over 3.5 years, or $4.3 billion USD (€4.7 billion) over four years, due to the prevention and reduction of ESRD cases. This cost saving was sustained throughout the course of therapy with losartan. This finding is important, as the annual cost for treating ESRD in the United States exceeds $12 billion USD (€13 billion), and is expected to reach $28 billion USD (€30 billion) by the year 2010.
"The reason for a potentially substantial reduction in medical expenditures -- not just in the United States but worldwide -- is that the cost of ESRD treatment is very expensive," said Dr. Herman. "This is particularly important since the number of patients with Type 2 diabetes and kidney disease worldwide is expected to dramatically increase, making preventing or delaying the development of ESRD an essential health management goal. Physicians now have a very well-tolerated drug that can help these patients to protect their kidneys, which will in turn positively impact the economics of our society."
About hypertension, Type 2 diabetes and kidney disease:
Approximately 146 million people worldwide have Type 2 diabetes, affecting 90 to 95 percent of patients with the disease, and this number is expected to double to 300 million by 2025. This form of diabetes usually occurs later in life and is often associated with increased body weight, hypertension and abnormalities of blood lipids. In fact, hypertension is two to three times more common in patients with Type 2 diabetes and kidney disease than in patients without diabetes.
Individually, diabetes and hypertension increase the risk of kidney disease, as well as cardiovascular disease; together, the risks rise dramatically. Diabetes and hypertension damage the tiny blood vessels in the kidney that act as filters to remove wastes from the blood. It is estimated that 20 to 30 percent of diabetic patients develop ESRD (the need for long-term dialysis or transplantation). Diabetes is the leading cause of ESRD in the United States and many other countries worldwide. About 30 percent of those undergoing dialysis and 15 percent of those receiving their first kidney transplant die within two years.
About Losartan:
In the Philippines, losartan or Cozaar is indicated for the treatment and control of high blood pressure. Losartan is contraindicated in patients who may be allergic to any of its components. The use of the medicine during pregnancy and while breast-feeding is not recommended. Likewise, the safety and effectiveness of losartan has not been established in children.
Launched in 1994, losartan was the first in a new type of hypertension medications called angiotensin II antagonists (AIIAs). Losartan and its companion product losartan plus hydrochlorothiazide (Hyzaar) are the world’s most widely prescribed medications in this class and the second highest selling antihypertensives worldwide. One major and consistently observed advantage of these agents is their excellent tolerability, which is comparable to placebo, helping patients to stay on therapy and allowing physicians to help patients control the course of their disease. Losartan and losartan plus hydrochlorothiazide have been prescribed to more than ten million patients since their introduction.
New data from the landmark RENAAL (Reduction of Endpoints in Non-Insulin Dependent Diabetes Mellitus with the Angiotensin II Antagonist Losartan) study show that treatment with the antihypertensive losartan not only helps hypertensive patients with Type 2 diabetes and kidney disease by protecting their kidneys, but also benefits society by providing an important cost savings. The analysis found that the United States health care system alone could save more than $3 billion USD (€3.3 billion) over 3.5 years, increasing to more than $4 billion USD (€4.7 billion) over four years, by treating these patients with losartan. The new data was recently presented at the American Society of Nephrology/International Society of Nephrology World Congress in San Francisco, California, USA.
Results from RENAAL indicated that treatment with losartan can effectively protect the kidney and reduce the risk of developing end-stage renal disease (ESRD) in hypertensive patients with Type 2 diabetes and kidney disease. ESRD is a serious and costly condition in which dialysis or transplantation is required for survival. Losartan is already the number two branded antihypertensive worldwide, and is the leading and most prescribed agent in the newest class of highly effective and well-tolerated antihypertensives known as angiotensin II antagonists (AIIA).
"The economic evaluation of the RENAAL study found that treatment with losartan not only reduces the risk of ESRD, but also could result in substantial cost savings," said William H. Herman, M.D., M.P.H. Professor of Internal Medicine and Epidemiology, University of Michigan, Ann Arbor, Michigan, United States, and lead author of the analysis. "These findings are particularly important, given the number of cases of ESRD that are presently challenging our health care system, combined with both the current shortages of nursing and technical staff needed for dialysis and the projected future shortage of nephrologists."
An economic evaluation of the RENAAL study, which was conducted in the United States, showed that losartan dramatically reduced the number of days that patients spent with ESRD (defined as initiation of dialysis or transplantation). Over 3.5 years, treatment with losartan resulted in 33.6 fewer days per patient with ESRD, and 46.9 fewer days per patient over four years. This reduction in ESRD days produced a $5,152 USD (€5,658) savings in ESRD-related costs per treated patient, p=0.004, over 3.5 years. This saving increased to $7,191 USD (€7,897) at four years.
When extrapolating these findings to the estimated 595,000 Type 2 diabetic patients with proteinuria (protein in the urine) in the United States, treatment with losartan would result in the following:
• Prevention of 36,500 ESRD cases over 3.5 years, or 46,000 cases over four years;
• Avoidance of an estimated 55,000 patient years of ESRD over 3.5 years, or 76,500 patient years of ESRD over four years;
• Savings of approximately $3.1 billion USD (€3.3 billion) over 3.5 years, or $4.3 billion USD (€4.7 billion) over four years, due to the prevention and reduction of ESRD cases. This cost saving was sustained throughout the course of therapy with losartan. This finding is important, as the annual cost for treating ESRD in the United States exceeds $12 billion USD (€13 billion), and is expected to reach $28 billion USD (€30 billion) by the year 2010.
"The reason for a potentially substantial reduction in medical expenditures -- not just in the United States but worldwide -- is that the cost of ESRD treatment is very expensive," said Dr. Herman. "This is particularly important since the number of patients with Type 2 diabetes and kidney disease worldwide is expected to dramatically increase, making preventing or delaying the development of ESRD an essential health management goal. Physicians now have a very well-tolerated drug that can help these patients to protect their kidneys, which will in turn positively impact the economics of our society."
About hypertension, Type 2 diabetes and kidney disease:
Approximately 146 million people worldwide have Type 2 diabetes, affecting 90 to 95 percent of patients with the disease, and this number is expected to double to 300 million by 2025. This form of diabetes usually occurs later in life and is often associated with increased body weight, hypertension and abnormalities of blood lipids. In fact, hypertension is two to three times more common in patients with Type 2 diabetes and kidney disease than in patients without diabetes.
Individually, diabetes and hypertension increase the risk of kidney disease, as well as cardiovascular disease; together, the risks rise dramatically. Diabetes and hypertension damage the tiny blood vessels in the kidney that act as filters to remove wastes from the blood. It is estimated that 20 to 30 percent of diabetic patients develop ESRD (the need for long-term dialysis or transplantation). Diabetes is the leading cause of ESRD in the United States and many other countries worldwide. About 30 percent of those undergoing dialysis and 15 percent of those receiving their first kidney transplant die within two years.
About Losartan:
In the Philippines, losartan or Cozaar is indicated for the treatment and control of high blood pressure. Losartan is contraindicated in patients who may be allergic to any of its components. The use of the medicine during pregnancy and while breast-feeding is not recommended. Likewise, the safety and effectiveness of losartan has not been established in children.
Launched in 1994, losartan was the first in a new type of hypertension medications called angiotensin II antagonists (AIIAs). Losartan and its companion product losartan plus hydrochlorothiazide (Hyzaar) are the world’s most widely prescribed medications in this class and the second highest selling antihypertensives worldwide. One major and consistently observed advantage of these agents is their excellent tolerability, which is comparable to placebo, helping patients to stay on therapy and allowing physicians to help patients control the course of their disease. Losartan and losartan plus hydrochlorothiazide have been prescribed to more than ten million patients since their introduction.
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