Cost-effective Prevention of Renal Failure in Type 2 Diabetics Using Losartan

SummaryA previous clinical trial (RENAAL) has demonstrated that co-administration of losartan, an angiotensin-II-receptor antagonist, with existing conventional antihypertensive therapy (CT) reduces the risk of development of end-stage renal disease (ESRD) in type 2 diabetes patients with nephropathy compared with CT alone.The objective of this study was to evaluate the effect of losartan and CT compared with CT alone on the economic cost associated with ESRD in the Nordic region.The analysis was performed separately for Denmark, Finland, Norway and Sweden using country-specific data on practice patterns and costs of modalities of renal replacement therapy. Average medical costs during the first year of ESRD for a diabetic patient were €53,235 in the Nordic region. Cost-savings due to reduced ESRD incidence with losartan were €5,591 (Denmark), €6,842 (Finland), €7,025 (Norway) and €6,776 (Sweden) per patient over 4 years. The additional cost of losartan during this period was between €1,130 and €1,473. Over 4 years, net cost-savings were €4,118 (Denmark), €5,395 (Finland), €5,720 (Norway) and €5,646 (Sweden).The nephroprotective effects of losartan may be associated with important cost-savings in the Nordic region.