NCPA - National Center for Policy Analysis


July 28, 2005

Angiotensin-converting enzyme (ACE) inhibitors slow renal disease progression and reduce cardiac morbidity and mortality in patients with diabetes. Patients' out-of-pocket costs pose a barrier to using this effective therapy. Providing diabetics with a free supply of these drugs could save Medicare billions of dollars over a decade, according to a study published in the Annals of Internal Medicine.

Allison B. Rosen, an assistant professor of medicine at the University of Michigan who led the study, says giving the drugs to patients would be far cheaper than the cost of treating patients who suffer more severe symptoms:

  • About 0.6 percent of Medicare beneficiaries have kidney failure, but the cost of treatment for the condition accounts for 6 percent of the total budget of the program.
  • Only about three of the eight million U.S. residents ages 65 or older who have diabetes take ACE inhibitors, in part because of the $233 annual cost of the medications.

Using computer simulations, researchers estimated how much Medicare would save through the provision of ACE inhibitors at no cost to Medicare beneficiaries with diabetes:

  • They found that first-dollar coverage would increase the rate of ACE inhibitor use among that population from 40 percent to 60 percent, and save both lives and money.
  • Medicare would save $1,606 over the lifetime of each diabetic patient.

Overall, the first-dollar coverage of ACE inhibitors for beneficiaries with diabetes appears to extend life and reduce Medicare program costs; a reduction in program costs may result in more money to spend on other health care needs of the elderly, conclude the researchers.

Source: Alex Raksin, "Study Sees Cost Savings in Free Drugs for Diabetics," Los Angeles Times, July 19, 2005; based upon: Allison B. Rosen et al., "Cost-Effectiveness of Full Medicare Coverage of Angiotensin-Converting Enzyme Inhibitors for Beneficiaries with Diabetes," Annals of Internal Medicine, vol. 143, issue 12, July 19, 2005.

For Annals abstract:


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