Study Sees Cost Savings in Free Drugs for Diabetics

Providing diabetics with a free supply of drugs that lower their blood pressure could save Medicare billions of dollars over a decade, according to a study published today in the Annals of Internal Medicine.

The drugs, known as ACE inhibitors, prevent heart attacks, strokes and kidney failure in diabetics by blocking the effects of an enzyme that raises blood pressure.

Dr. Allison B. Rosen, an assistant professor of medicine at the University of Michigan who led the study, said giving the drugs to patients would be far cheaper than the cost of treating patients who suffer more severe symptoms.

For example, while 0.6% of Medicare patients suffer kidney failure, 6% of Medicare’s budget is used to treat them, she said.

“Over 10 years, the savings would amount to several billion dollars,” Rosen said.

Although 8 million Medicare-eligible Americans have diabetes, about 3 million take ACE inhibitors, in part because of the cost, estimated at about $233 a year.

On the market for nearly two decades, ACE inhibitors treat multiple symptoms of diabetes, including lowering production of hormones that raise blood pressure and reducing levels of a protein in urine that leads to infections.

Diabetes also can be treated with other drugs, such as less expensive diuretics and more expensive statins.

Rosen focused on ACE inhibitors because she said they were the only viable treatment for kidney failure, the most expensive complication of diabetes.

Using computer simulations, Rosen and colleagues found that providing free ACE inhibitors to patients could increase use of the drugs from 40% of patients to 60%. The study estimated that the move would save Medicare $1,606 over the lifetime of each diabetic patient.

Peter Ashkenaz, a spokesman for Medicare, said it remained unclear how many people would take the drugs even if they were free. The drugs must be taken daily.

Rosen acknowledged that the effect of providing free drugs was uncertain. But she said she thought her estimate that 60% of diabetic patients would use the free drugs was reasonable.

Rosen said when the new Medicare prescription drug benefit takes effect in January, it would cover about one-third of the cost of ACE inhibitors.

The study found the new benefit would increase the percentage of diabetics who use ACE inhibitors from 40% to 47%, saving Medicare $922 over the lifetime of each patient.