Salt and water undermine $33bn hypertension market

pharmafile | October 23, 2003 | News story | |   

A new study claims that generic salt and water diuretics work as well as two of the biggest selling anti-hypertension treatments in lowering blood pressure, promising huge savings for health systems.

The Anti-Hypertensive and Lipid-lowering Treatment to Prevent Heart Attack Trial (ALLHAT) found the diuretic chlorthalidone helped prevent fatal heart attacks just as effectively as Pfizer's calcium channel blocker Istin (amlodipine) and AstraZeneca's ACE inhibitor Zestril (lisinopril).

Dr Charles L'Enfant, Director of the National Heart, Lung and Blood Institute in Washington DC, and trial leader, says unsubstantiated claims of superiority for patented products has helped boost their sales in place of generic medicines.

But market analysts Datamonitor says flaws in the study will enable pharma companies to maintain their sales.

An "artificial treatment regimen" and a contentious primary end-point for the trial are among several of its potential weaknesses. Datamonitor Cardiovascular analyst Christine Hollidge says:"Whether these limitations explain the surprising result or whether the outcome would hold anyway remains open to question.

"Certainly, despite a number of comparative trials, the only class to demonstrate an efficacy advantage over another in terms of morbidity has been the ARBs in the recent LIFE study for losartan [MSD Cozaar]".

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