Researcher Dr Anthony Grosso (centre), with co-authors Pritesh Bodalia (left) and Professor Aroon Hingorani (right).
A team of researchers including pharmacists, a cardiologist, a health economist and clinical pharmacologists, compared a market leading drug for treating high blood pressure and heart failure with a cheaper alternative.
The team pooled data from 14 studies over a decade involving 16,000 patients treated with either losartan or candesartan, and used statistical methods and health economic analyses to compare the two agents. The team found no strong evidence to support the prescribing of the more expensive product and suggested changing NHS prescribing guidance as a result. The NHS currently spends £250m a year treating around 1.5 million patients with this particular class of drug. Treating all these patients with generic losartan would cost only £50m a year.
The lead researcher, Dr Anthony Grosso (UCLH Formulary pharmacist) said: “Our comparative research showed that candesartan reduced blood pressure slightly more than losartan. However the difference is unlikely to be clinically significant and cost effective, particularly when it is prescribed in combination with other drugs. As these drugs are predominantly prescribed in primary care the financial benefit will fall to primary care organisations. However we’re delighted to be able to help support them to make the most cost-effective prescribing decisions for their patients.”
The study has also been welcomed by Dr Rubin Minhas, clinical director of the British Medical Journal's Evidence Centre. He said: “It is a delicate balancing act between what doctors think are best for their patients and making the best use of hard-pressed budgets. That is why reviews like this are so important.
“NHS prescribing is a complex issue and it is vital that the proposed changes to the NHS ensure that doctors are making high-quality clinical decisions that are also cost- effective.”
The full study is published in this month’s International Journal of Clinical Practice and is available here.