Inexpensive diuretics were shown to be as good as, or better, than brand name medications.

Why did the Allhat trial have so little impact? That’s a question that a recent NY Times story tried to answer.

For me, the biggest impact was that the drugs that were brand-name during the trial, are now generic. Lisinopril and amlodipine (Norvasc) are on many insurers’ generic tier. Also, I have always found thiazide diuretics to be relatively weak antihypertensives when used alone.

One can learn from this expensive debacle. One is that physician payment mechanisms need to be tied with the results of such comparative effectiveness studies. Nothing influences prescribing behavior like money.

The other is that these studies take so long to complete that the questions being studied are obsolete by the time they’re answered.

topics: allhat, hypertension