Can some medicines do so much good they should be free? The answer may well be yes, according to a University of Michigan study published in the  Annals of Internal Medicine. Researchers found, on the basis of their new computer model, that if a group of medicines called ACE inhibitors was provided for free to the 8 million Americans over age 65 suffering from diabetes, the result would be fewer heart attacks, strokes and kidney failures, which would translate into a huge net savings in health care costs for Medicare. And, of course, the drugs would save lives.

The researchers based their model on a generic ACE inhibitor that costs around $200 to $300 per year, though bulk purchasers such as the Department of Defense health care system pay much less. By combining efficacy data from clinical trials of the drug with epidemiological data that allowed them to predict the numbers of diabetics who, left untreated, would be likely to suffer heart attacks, stroke and kidney failure, and using standard government and industry data to estimate the average price tag for medical treatment of those events, they concluded the following: If Medicare paid for the cost of the drug for all adults over age 65 who have diabetes, added to the existing cost of all their healthcare until death, the total savings would be $1,600 over a lifetime for each Medicare recipient.

Right now, cost—even when it is nominal—and lack of awareness keep 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 the patients who would benefit from these drugs  actually  take them.

"If only seven percent more people started taking ACE inhibitors when they were offered at no cost," says lead author Dr. Allison Rosen, "Medicare would still save money. The more people that take advantage of the no-cost drugs, the bigger the savings for Medicare over the long term." Saved lives and saved money —what's not to like?