Billions Spent on New Hypertension Drugs, Study Says

Americans spend billions of dollars a year on costly new blood pressure drugs that are not proven superior to cheaper medications, a study says.

“The last 10 to 12 years have shown some remarkable changes in the proportion of different types of hypertension drugs used,” said Dr. Jeffrey A. Cutler, a federal researcher and the study’s co-author.

“These trends have occurred in the absence of any large-scale clinical comparisons of what the various drugs might do to prevent heart disease, strokes and other complications of high blood pressure,” he said.

The older drugs--diuretics and beta blockers--have fallen from favor as rapidly as the newer drugs--calcium antagonists and ACE inhibitors--have gained popularity, the researchers reported in today’s issue of the Archives of Internal Medicine, published by the American Medical Assn.

Some doctors are quick to defend the newer drugs, which they said cause far fewer side effects than the older ones and offer other medical advantages as well.

The difference in the cost of the drugs is striking. In 1992, a month of diuretic treatment averaged $8.25 wholesale, compared with $23.77 for beta blockers, $36.14 for ACE inhibitors and $47.63 for calcium antagonists, the researchers said.

With 25 million Americans taking blood pressure medication, the additional cost of using the more expensive class of drugs is about $10 billion, nearly equivalent to the research budget of the National Institutes of Health, they said.

Without a good medical reason to use a newer drug, the older ones should be the first line of defense against hypertension, the researchers said, echoing the conclusion of an expert panel convened by the Heart, Lung and Blood Institute in 1993.