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Lower-Cost Drugs Can Help Heart Patients

April 1, 2005
Millions of Americans who should be taking medicine to treat high blood pressure and heart conditions but don’t due to their high cost could benefit from a new report that shows consumers how to save $1,000 to $2,000 a year by taking lower-cost medications.

The free Consumers Union report, available at www.CRBestBuyDrugs.org, identifies seven beta-blockers as Best Buy picks – meaning they are just as effective and safe as similar drugs, but cost significantly less.

For example, in treating high blood pressure, three generics were identified as Best Buy Drugs that cost less than $25 a month. In comparison, the brand-name versions of these drugs can cost up to $90 a month.

The Consumer Reports Best Buy Drugs project is a free, public education effort by Consumers Union, nonprofit publisher of Consumer Reports. It is designed to help consumers and doctors find the most effective and affordable medicines in this era of spiraling drug costs. The reports are based on unbiased, scientific-based evidence that is peer-reviewed by medical experts.

“By identifying effective and lower-cost drugs, millions more people who should be taking a beta-blocker may now be able to afford one,” said Gail Shearer, project director of Consumer Reports Best Buy Drugs. “High blood pressure is chronically under-treated in the United States, with only 30 percent of those who have the condition getting the medicines, care and blood pressure control they need.”

Beta-blockers are among the most widely prescribed medicines in the nation. They are used to treat high blood pressure and heart ailments, including angina (the chest pain that occurs in people who have coronary artery disease); abnormal heart rhythms, coronary artery blockages and heart failure. They are also used to prevent repeat heart attacks in people who have already had one.

The seven Best Buy beta-blockers are:

• For high blood pressure – metoprolol tartrate, nadolol, and propranolol
• For angina – atenolol, metoprolol tartrate, nadolol, and propranolol
• After a heart attack – atenolol, metoprolol tartrate, and propranolol
• For mild heart failure – bisoprolol and metoprolol succinate (Brand name: Toprol XL)
• For severe heart failure – carvedilol (Brand name: Coreg).

The choices are based in part on an assessment of the scientific evidence conducted by the Drug Effectiveness Review Project (DERP), affiliated with the Oregon Health & Science University.

Several of the Best Buy beta-blocker choices were also driven by the Food and Drug Administration’s approval of the chosen medicines against specified conditions. Cost was a factor in choosing all but one of the medicines.

In the high blood pressure category, for example, the generics, metoprolol tartrate, nadolol and propranolol cost less than $25 a month on average, with some doses less than $15 a month. In contrast, the brand version of these four drugs cost two to four times as much. For instance, the twice-daily 20 mg dose0 of generic propranolol costs around $13 a month. The 20 mg once-daily dose of Inderal, the brand name version of propranolol, costs $44 a month.

By the same token, some generics are more expensive than others. For example, the 200 mg twice-a-day dose of generic acebutolol costs $43 a month, even though it is comparable to 20 mg propranolol, which rings in at $13 a month.

“An astute shopper can save money if they need a beta-blocker,” Shearer said. “For the vast majority of people, there is no reason to take a more expensive drug. The least expensive ones are just as good and, in fact, in some cases there’s more evidence supporting their effectiveness.”

The exception is in the treatment of people who have heart failure. Two brand-name drugs have been shown effective against this ailment, which occurs when the heart begins to lose its ability to contract and pump blood efficiently.

They are metoprolol succcinate (Toprol XL), which costs from $32 to $69 a month on average, depending on the dose needed; and carvedilol (Coreg), which costs around $124 a month and has been shown to have superior effectiveness in the treatment of people with severe heart failure.

Beta-blockers join four other drug categories on the www.CRBestBuyDrugs.org Web site: cholesterol-lowering statins, heartburn and acid reflux treatments, anti-inflammatory pain relievers, and antidepressants. A new category is uploaded to the Web site each month.

Consumers Union also is coordinating on-the-ground outreach to seniors and low-income residents in Atlanta and Sacramento. The experiences in these cities will help determine the most effective methods for reaching consumers throughout the nation who need information on prescription drug effectiveness and pricing.

Consumer Reports Best Buy Drugs combines national-level data on drug prices with assessments from the Drug Effectiveness Review Project, now a 12-state initiative. Drug cost information reflects average retail prices paid in cash by consumers at the pharmacy. The project is funded in part with a grant from the Engelberg Foundation, a charitable trust, and a grant from the National Library of Medicine of the National Institutes of Health.

For a complete list of beta-blockers and their prices go to www.CRBestBuyDrugs.org and access the full 18-page beta-blocker report.

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