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An economic evaluation of rofecoxib versus NSAIDs in osteoarthritis

Russo, P; Attanasio, E; Baio, G; Degli Esposti, L; Buda, S; Degli Esposti, E; Caprino, L; (2001) An economic evaluation of rofecoxib versus NSAIDs in osteoarthritis. PharmacoEconomics - Italian Research Articles , 3 (2) pp. 81-89.

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Objective: Randomised clinical trials have demonstrated that rofecoxib has a better gastrointestinal tolerability profile than conventional nonsteroidal antiinflammatory drugs (NSAIDs) in osteoarthritis, which results in a reduced utilisation of gastroprotective agents (GPA). The aim of this study was to estimate, from the national healthcare system perspective, the total drug costs in patients switched from NSAIDs plus GPAs to rofecoxib. Design: In this longitudinal, observational study, drug prescriptions for symptomatic treatment of osteoarthritis were recorded. A decision tree was used to compare the mean daily drug cost of the following therapeutic options for ostheoarthritis: conventional NSAIDs and rofecoxib/conventional NSAIDs. Setting: Azienda Unità Sanitaria Locale 110, Ravenna, Italy. Patients: 56,827 patients affected by osteoarthritis were monitored from January 1997 to December 1999. Of this group, we considered the first 2,935 patients who were examined by 21 General Practitioners in the period July 2000-October 2000, in order to point out changes in GPAs co-prescription after the introduction of rofecoxib in the Italian market. Interventions: Alternative treatments compared were: NSAIDs either alone or combined with GPAs (NSAIDs option), and just after the introduction of rofecoxib, NSAIDs or rofecoxib alone and NSAIDs or rofecoxib combined with GPAs (rofecoxib/NSAIDs option). Main outcome measures and results: 27,511 out of 56,827 patients (48.4%; IC 95%: 48.0-48.8%) treated with NSAIDs also received a GPA co-medication. In the aforementioned subgroup of 2,935 patients, 1,814 (62%) received multiple prescriptions of NSAIDs or rofecoxib. In this subgroup, rofecoxib was associated with a statistically significant reduction of GPAs utilisation of 58.8% (IC 95%: 30.7-80.1; p = 0.012) compared with what was recorded during treatment with NSAIDs. In fact, the mean daily cost per patient of the NSAIDs option was € 1.66 versus € 1.55 of the rofecoxib/NSAIDs option (6.6% lower). Conclusions: Our preliminary results suggest that the use of rofecoxib is associated with cost savings in terms of total drug costs compared with conventional NSAIDs.

Type: Article
Title: An economic evaluation of rofecoxib versus NSAIDs in osteoarthritis
URI: http://discovery.ucl.ac.uk/id/eprint/1307230
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