An economic evaluation of Losartan therapy in type 2 diabetic patients with nephropathy: an analysis of the RENAAL study adapted to France

Diabetes Metab. 2003 Feb;29(1):29-35. doi: 10.1016/s1262-3636(07)70004-6.


Background: The RENAAL study enrolled 1,513 patients with type 2 diabetes mellitus and nephropathy defined by the presence of proteinuria (urinary albumin: creatinine ratio 300 mg/g or proteinuria > 500 mg per day). Compared to placebo, losartan therapy reduced by 16% (p=0.02) the risk of a composite endpoint (doubling of baseline serum creatinine level, end stage renal disease, or death) and by 28% (p=0.002) the risk of progression to end stage renal disease (ESRD).

Methods: The objective of this study was to compare, using French economic data, the additional cost of losartan therapy with the savings in cost generated by a decrease in the number of end stage renal disease days. Prospectively collected health care resource utilization were used (N(losartan)=751, N(placebo)=762). The follow-up period was 4 years.

Results: The mean cumulative cost of losartan over 4 years was 1,603 euros per patient. The reduction in the number of ESRD days over 4 years in patients treated with losartan significantly decreased costs associated with ESRD by 7,438 euros per patient (CI 95%: 3,029 euros - 11,847 euros, p=0.001). Compared to the placebo group, the average cost per patient over 4 years in the losartan group was lower by 5,834 euros (CI 95%: 1,407 euros - 10,301 euros, p=0.01).

Conclusion: In addition to the medical benefit, this analysis demonstrated the economic relevance of treatment with losartan in type 2 diabetic patients with nephropathy.

Publication types

  • Clinical Trial
  • Comparative Study
  • Multicenter Study
  • Randomized Controlled Trial

MeSH terms

  • Antihypertensive Agents / economics
  • Antihypertensive Agents / therapeutic use
  • Blood Pressure / drug effects
  • Body Mass Index
  • Continental Population Groups
  • Creatinine / metabolism
  • Diabetes Mellitus, Type 2 / drug therapy*
  • Diabetic Nephropathies / drug therapy*
  • Disease Progression
  • Double-Blind Method
  • Female
  • France
  • Humans
  • Kidney Failure, Chronic / prevention & control*
  • Losartan / economics*
  • Losartan / therapeutic use*
  • Male
  • Myocardial Infarction / epidemiology
  • Proteinuria
  • Risk Factors
  • Smoking
  • Treatment Outcome


  • Antihypertensive Agents
  • Creatinine
  • Losartan