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Newer, more expensive hypertension drugs are no more effective

A 2002 study concluded that generic high blood pressure pills were actually more effective than the new, very expensive hypertension drugs marketed by Pfizer and others.  At pennies per day, the generics were expected to save Medicare, health insurers, consumers, and taxpayers a significant sum.

The older drugs are called diuretics.   The newer drugs, which cost as much as 20 times more, ainclude calcium channel blockers and ACE inhibitors.  They have captured about 73 percent of the hypertension market.  The newest drug, Novartis' Diovan, was not included in the study.  It costs from $1.88 to $3.20 per dose, compared with 8 to 31 cents for a diuretic.

The impact of the study was blunted when the data was attacked by the pharmaceutical industry and a steering committee including physicians earning as much as $200,000.00 each in speaking fees, annually, from Pfizer.  When Pfizer's new drug Cardura turned out to be much less safe and was discontinued from the 42,000 patient study, Pfizer sales reps were give a script to reassure physicians and to encourage them to continue to prescribe it.  Pfizer stopped promoting the drug after it lost patent protection in late 2000 and gradually lost market share.  Norvasc drug sales continued to rise, with heavy marketing, until it lost patent protection in 2007.

All three of the remaining drugs proved equally effective in preventing heart attacks, however, patients receiving Norvasc calcium channel blocker were 38 percent more likely to suffer heart failure while patients receiving ACE inhibitors from AstraZeneca demonstrated a 15 percent higher risk of stroke and a 19 percent higher risk of hear failure.  At the time, the diuretic cost $25 dollars per year, while the ACE inhibitor cost $250.00 per year and the calcium channel blocker cost $500.00 per year.  An Australian study completed shortly after the US study concluded that the ACE inhibitor was more effective in lowering blood pressure, and critics argued that the US study used a second drug to control intractable hypertension that worked more effectively with diuretics than with the newer drugs.

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