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Are some medicines so good they should be free? In diabetes, the answer may be yes

ANN ARBOR, Mich. -- Nothing in life is free, the old saying goes. But maybe some things should be, according to a new University of Michigan Health System study.

Specifically, researchers find, a group of medicines called ACE inhibitors should be available at no cost to the 8 million Americans over age 65 who have diabetes. These drugs are so beneficial for these patients that even giving them away ultimately would save the Medicare system and society large amounts of money by preventing heart attacks, strokes and kidney failure, the study shows.

And of course, the drugs would save lives, and make life better for patients. The findings, based on a sophisticated computer analysis, appear in the July 19 Annals of Internal Medicine.

Right now, cost or lack of awareness keeps many older diabetes patients from taking ACE inhibitors, which reduce blood pressure and cut the risk of diabetes-related problems in the cardiovascular system and kidneys. In fact, fewer than half of patients who should take them actually do take them.

The new study is especially timely because for the first time ever, Medicare soon will begin covering part of the cost of prescription drugs for people over age 65. That should increase the use of ACE inhibitors by seniors with diabetes, as their out-of-pocket cost for the drug declines.

But under the new Medicare plan, seniors will still pay for part of their drug costs in the form of premiums, deductibles and co-pays -- and research has shown that even small out-of-pocket costs keep many people from taking drugs that can help them.

Says lead author Allison Rosen, M.D., M.P.H., Sc.D., "Patients' out-of-pocket costs such as co-pays are a blunt instrument designed to keep patients from over-using medications, but they create barriers to the use of essential and non-essential medications alike. Our analysis shows that removing all patient costs for diabetes patients taking ACE inhibitors could save M
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Contact: Kara Gavin
kegavin@umich.edu
734-764-2220
University of Michigan Health System
18-Jul-2005


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