Losartan: a pharmacoeconomic review

SummaryThe angiotensin II antagonist losartan has been clinically studied in several patient populations including type 2 diabetes mellitus (T2DM) with nephropathy, hypertension with left ventricular hypertrophy, and the elderly with heart failure. The aim of this paper is to provide a review of the health economic evaluations based on the clinical trial results of losartan. In patients with T2DM and nephropathy, losartan was shown to be cost saving in 14 countries and the EU. Net cost savings per patient, after factoring in the drug cost of losartan, ranged from 56 and 5, 149 over a 3. 5 year time horizon. For the two countries with published lifetime projections, the US and Mexico, net cost savings per patient were 24, 632 and 2, 223, respectively. In patients with hypertension and left ventricular hypertrophy, losartan as compared with atenolol was found to be cost effective in five countries and cost saving in one country. The incremental cost-effectiveness ratios ranged from 1, 274 to 5, 764 per quality-adjusted life year gained for four of the countries and was 1, 083 per life-year gained in one country. The other country evaluation reported a 20 net cost saving per patient. Pharmacoeconomic evaluations in other patient populations comparing losartan with the angiotensin-converting enzyme inhibitor captopril generally did not demonstrate differences in health economic outcomes.