High blood pressure treatment just got cheaper

WASHINGTON — For many of the one-in-three American adults who have high blood pressure, a cheaper alternative to brand-name medications is about to become available.

Losartin, the angiotensin II receptor blocker marketed under the brand names Cozaar and Hyzaar (the latter of which combines losartin with the diuretic hydrochlorothiazide) for more than a decade, will become available in generic formulations, following an FDA decision announced this week.

Four drug makers have won the FDA’s blessing to make and market the hypertension drugs in generic forms. Wasting no time, the first company to receive broad FDA approval to market the generic drug, Teva, announced Thursday the launch of its losartin potassium-film-coated tablets in 25-milligram, 50-milligram and 100-milligram strengths.

If you’re a patient being treated with other brand-name angiotension receptor blockers for hypertension — Atacand, Avapro and Diovan — you may have to wait for less expensive drugs. Atacand won’t be available in generic form before 2011 at the earliest, and Avapro and Diovan are not expected to reach the market in generic form before 2012.

The FDA’s Office of Generic Drugs states flatly that generic drugs are the same as the brand-name first-to-market drugs they copy — same active ingredient, same means of action, same safety and effectiveness profile — they’re just much cheaper. But the formulations in which those active ingredients are packaged do change when they are reproduced as generics. For a very small number of people and with a few types of drugs, pharmacologists acknowledge that that can make a difference in how — or even how well — a drug works.

So, if the size, shape, color or brand marking of your regular prescription blood pressure medication changes in the next few months (and if it suddenly becomes less expensive), rejoice over your lower bill. But also, be sure to ask the pharmacist if you have been switched to a generic version of the drug your physician originally prescribed. And for a couple of weeks after switching to a generic, check your blood pressure a bit more regularly to make sure your hypertension is still under control with the medication.

One more warning: There are five other classes of medications used to treat high blood pressure, and all do so by different means than the angiotension II receptor blockers. Insurance companies and pharmacy benefits managers are aggressive in trying to switch patients to a new generic drug if it can save money, even if it means switching a patient to a new class of drugs. The practice is called therapeutic substitution. Sometimes, it can often save you money while managing your condition just fine. But for some individuals, another class of medication won’t work as well or may not be recommended.

Again, ask your pharmacist if you don’t recognize the medication you’re getting, and check with your physician if the switch is something you haven’t discussed.

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