—We appreciate the thoughtful letter by Dr Hume and we agree with her comments and concerns.Stason1 recently estimated that the annual direct costs for hypertension, including the costs of medications, office visits, and laboratory tests, were more than $10 billion. The costs of medications represent about 70% to 80% of these costs.2The degree to which physicians are responding to the evidence from recent clinical trials is an empiric question. A center for the assessment of pharmaceutical effectiveness, recently proposed by Ray and colleagues,3 would help to evaluate the relative cost-effectiveness of alternative therapies for a number of diseases and conditions, including hypertension.
Psaty BM. Diuretics and β-Blockers for Hypertension: Seeking Respect-Reply. JAMA. 1994;271(12):904. doi:10.1001/jama.1994.03510360028023