The Different Therapeutic Choices with ARBs. Which One to Give? When? Why?

Dézsi, Csaba András

doi:10.1007/s40256-016-0165-4

Cited by 44 publications

(42 citation statements)

References 113 publications

(118 reference statements)

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Four combinations incorporated a brand-name angiotensin receptor blocker, which is a class with similar clinical effects. 25,26 The other 2 therapeutic substitutions would have exchanged omeprazole for esomeprazole (in Vimovo) and finasteride for dutasteride (in Jalyn). Meta-analyses have not found significant differences in efficacy for symptom relief among patients taking different proton pump inhibitors.…”

Section: Discussionmentioning

confidence: 99%

Medicare Spending on Brand-name Combination Medications vs Their Generic Constituents

Sacks

Lee

Kesselheim

et al. 2018

JAMA

View full text Add to dashboard Cite

IMPORTANCE Brand-name combination drugs can be more expensive than the sum of their components, especially when the constituent products are available as generic medications. The potential savings that could be achieved using generic components is not known.OBJECTIVE To estimate the additional cost to Medicare of prescribing brand-name combination medications instead of generic constituents. DESIGN, SETTING, AND PARTICIPANTSRetrospective analysis for 2011 through 2016 using the Medicare data set of Part D beneficiaries prescribed any of the 1500 medications that accounted for the highest total spending in 2015. Brand-name combination drugs that had identical or therapeutically equivalent generic constituents were included.EXPOSURES Brand-name, oral combination medications with constituents available either as generic drugs or therapeutically equivalent generic substitutes. MAIN OUTCOMES AND MEASURESThe estimated difference between the amount spent by Medicare on brand-name combination drugs and the estimated amount that would have been spent on substitutable generic components.RESULTS Among the 1500 medications evaluated, 29 brand-name combination medications were separated into 3 mutually exclusive categories: constituents available as generic medications at identical doses (n = 20), generic constituents at different doses (n = 3), and therapeutically equivalent generic substitutes (n = 6). For the constituents available as generic medications at identical doses category, total spending by Medicare in 2016 on the brand-name combination products was $303 million and the estimated spending for the generic constituents would have been $68 million, which is an estimated difference of $235 million. For the generic constituents at different doses category, total spending by Medicare in 2016 on the brand-name combination products was $232 million and the estimated spending for the generic constituents would have been $13 million, which is an estimated difference of $219 million. For the therapeutically equivalent generic substitutes category, total spending by Medicare in 2016 on the brand-name combination products was $491 million and the estimated spending for the generic constituents would have been $20 million, which is an estimated difference of $471 million. In 2016, the estimated spending for the generic constituents for these 29 drugs would have been $925 million less than the estimated spending for the brand-name combinations. For the 10 most costly combination products available during the entire study period, the listed Medicare spending could have been an estimated $2.7 billion lower between 2011 and 2016 if the generic constituents had been prescribed. CONCLUSIONS AND RELEVANCEIn 2016, the difference between the amount that the Medicare drug benefit program reported spending on brand-name combination medications and the estimated spending for generic constituents for the same number of doses was $925 million. Promoting generic substitution and therapeutic interchange through prescriber education and more ...

show abstract

Section: Discussionmentioning

confidence: 99%

Medicare Spending on Brand-name Combination Medications vs Their Generic Constituents

Sacks

Lee

Kesselheim

et al. 2018

JAMA

View full text Add to dashboard Cite

show abstract

“…6 As its efficacy is very low, eprosartan mesylate is administered in high doses. 7,8 Improving the solubility of eprosartan mesylate in water might improve its oral efficacy and circumvent the need for high doses.…”

Section: Introductionmentioning

confidence: 99%

The preparation and physicochemical characterization of eprosartan mesylate-laden polymeric ternary solid dispersions for enhanced solubility and dissolution rate of the drug

Yousaf

Zulfiqar²,

Shahzad

et al. 2019

Polim. Med.

View full text Add to dashboard Cite

Background. Eprosartan mesylate is a poorly water-soluble drug. It does not dissolve well in the aqueous gastrointestinal fluid, which means it is not absorbed well via the oral route, because a drug can cross cell membranes when it is dissolved in the gastrointestinal fluid. Objectives. The purpose of this research was to enhance the aqueous solubility and dissolution rate of eprosartan mesylate using the solid dispersion technique. Enhancing the solubility and dissolution leads to better absorption via the oral route. Material and methods. A number of eprosartan mesylate-laden polymeric solid dispersions were prepared with hydroxypropyl methylcellulose (HPMC) and polysorbate 80 by means of the solvent evaporation technique. The impact of the weight ratios of the constituents on the solubility and dissolution rate was studied in comparison with the plain drug. The formulation presenting the optimal solubility and dissolution underwent the solid-state characterization using X-ray diffraction (XRD), differential scanning calorimetry (DSC), scanning electron microscopy (SEM), and Fourier-transform infrared spectroscopy (FTIR). Results. Both polysorbate 80 and HPMC positively affected the solubility and dissolution of eprosartan mesylate. Conclusions. In particular, a ternary solid dispersion consisting of eprosartan mesylate, HPMC and polysorbate 80 at a weight ratio of 1:4.2:0.3 showed the highest solubility (36.39 ± 3.95 mg/mL) and dissolution (86.19 ±4.09% in 10 min). Moreover, the drug was present in the amorphous form in the solid dispersion with no covalent drug-excipient interactions.

show abstract

“…Telmisartan has a low rate of adverse effects, long duration of action, is well studied and is available in generic forms. Compared with some other generic ARBs, telmisartan absorption is less affected by food, is more effective when combined with a diuretic, is better documented to reduce cardiovascular events, and has a lower incidence of serious adverse effects . The addition of an ARB reduces amlodipine‐associated pedal edema and diuretic‐associated hypokalemia .…”

Section: Drug‐ and Dose‐specific Protocolmentioning

confidence: 99%

Scaling up effective treatment of hypertension—A pathfinder for universal health coverage

Frieden

Varghese²,

Kishore

et al. 2019

J of Clinical Hypertension

View full text Add to dashboard Cite

High blood pressure is the world’s leading cause of death, but despite treatment for hypertension being safe, effective, and low cost, most people with hypertension worldwide do not have it controlled. This article summarizes lessons learned in the first 2 years of the Resolve to Save Lives (RTSL) hypertension management program, operated in coordination with the World Health Organization (WHO) and other partners. Better diagnosis, treatment, and continuity of care are all needed to improve control rates, and five necessary components have been recommended by RTSL, WHO and other partners as being essential for a successful hypertension control program. Several hurdles to hypertension control have been identified, with most related to limitations in the health care system rather than to patient behavior. Treatment according to standardized protocols should be started as soon as hypertension is diagnosed, and medical practices and health systems must closely monitor patient progress and system performance. Improvement in hypertension management and control, along with elimination of artificial trans fat and reduction of dietary sodium consumption, will improve many aspects of primary care, contribute to goals for universal health coverage, and could save 100 million lives worldwide over the next 30 years.

show abstract

The Different Therapeutic Choices with ARBs. Which One to Give? When? Why?

Cited by 44 publications

References 113 publications

Medicare Spending on Brand-name Combination Medications vs Their Generic Constituents

Medicare Spending on Brand-name Combination Medications vs Their Generic Constituents

The preparation and physicochemical characterization of eprosartan mesylate-laden polymeric ternary solid dispersions for enhanced solubility and dissolution rate of the drug

Scaling up effective treatment of hypertension—A pathfinder for universal health coverage

Contact Info

Product

Resources

About