Free ACE inhibitors for diabetics could cut costs

In the US, Medicare could save money by covering the full cost of providing people with Diabetes with drugs called angiotensin-converting enzyme (ACE) inhibitors, according to new a research. ACE inhibitors prevent expensive complications, but patients' out-of-pocket costs for the drugs pose a barrier, the investigators explain.

"There is a rare opportunity to save lives and money that should be quite appealing to policymakers," said Dr. Allison B. Rosen from University of Michigan Health Systems. "It is a win-win situation: lives are saved, patients pay less, and Medicare pays less."

Rosen and colleagues evaluated the cost-effectiveness to Medicare, the health coverage program for the elderly, of full coverage of ACE inhibitors for beneficiaries with diabetes.

Under current practice, Medicare incurs a total discounted lifetime cost of $117,549 per beneficiary with Diabetes, the report in the Annals of Internal Medicine indicates.

Were Medicare to pay the full cost of ACE inhibitor therapy, that cost would decrease to $115,943 while increasing life expectancy by 3 months, the team calculates.

The researchers note that these findings held good for a wide range of estimates of kidney and heart risks, costs and discount rates, and savings persisted after including implementation of the new Medicare drug benefit.

Rosen said that as the medical benefit of a drug goes up, it would "make sense" to reduce the amount that a patient has to co-pay for the drug. "In the future, we hope that payers would consider tailoring drug co-payments on a drug-by-drug and person-by-person basis," she said.

SOURCE: Annals of Internal Medicine, July 19, 2005.