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Cost-effectiveness analysis of NSAIDs, NSAIDs with concomitant therapy to prevent gastrointestinal toxicity, and COX-2 specific inhibitors in the treatment of rheumatoid arthritis.
Rheumatol Int. 2005 Jan; 25(1):9-14.RI

Abstract

The objective was to assess the cost-effectiveness of nonsteroidal anti-inflammatory agents (NSAIDs), NSAIDs with concomitant therapy to prevent gastrointestinal (GI) toxicity, and cyclooxygenase-2 specific inhibitors (COX-2) in the treatment of rheumatoid arthritis (RA). Markov (state-transition) models were used to simulate a cohort taking disease-modifying antirheumatic drugs, low dose steroid, and one of the following strategies: (1) NSAIDs without prophylaxis, (2) NSAIDs with misoprostol, (3) NSAIDs with proton-pump inhibitor (PPI), or (4) COX-2. Costs were measured in 1999 US dollars and health effects are expressed as quality-adjusted life years (QALYs). COX-2 was the most cost-effective strategy for preventing GI toxicity. The incremental cost/effectiveness (C/E) ratio between COX-2 and no prophylaxis was 56,751 dollar/QALY. Although COX-2 are the best option (among the strategies analyzed) to prevent GI toxicity, the incremental C/E ratio between COX-2 and no prophylaxis is higher than 50,000 dollar/QALY.

Authors+Show Affiliations

The Hospital for Rheumatic Diseases, Department of Internal Medicine, Hanyang University College of Medicine, 133-792 Seoul, Korea.No affiliation info available

Pub Type(s)

Journal Article
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

13680139

Citation

Yun, Hyung Ran, and Sang-Cheol Bae. "Cost-effectiveness Analysis of NSAIDs, NSAIDs With Concomitant Therapy to Prevent Gastrointestinal Toxicity, and COX-2 Specific Inhibitors in the Treatment of Rheumatoid Arthritis." Rheumatology International, vol. 25, no. 1, 2005, pp. 9-14.
Yun HR, Bae SC. Cost-effectiveness analysis of NSAIDs, NSAIDs with concomitant therapy to prevent gastrointestinal toxicity, and COX-2 specific inhibitors in the treatment of rheumatoid arthritis. Rheumatol Int. 2005;25(1):9-14.
Yun, H. R., & Bae, S. C. (2005). Cost-effectiveness analysis of NSAIDs, NSAIDs with concomitant therapy to prevent gastrointestinal toxicity, and COX-2 specific inhibitors in the treatment of rheumatoid arthritis. Rheumatology International, 25(1), 9-14.
Yun HR, Bae SC. Cost-effectiveness Analysis of NSAIDs, NSAIDs With Concomitant Therapy to Prevent Gastrointestinal Toxicity, and COX-2 Specific Inhibitors in the Treatment of Rheumatoid Arthritis. Rheumatol Int. 2005;25(1):9-14. PubMed PMID: 13680139.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Cost-effectiveness analysis of NSAIDs, NSAIDs with concomitant therapy to prevent gastrointestinal toxicity, and COX-2 specific inhibitors in the treatment of rheumatoid arthritis. AU - Yun,Hyung Ran, AU - Bae,Sang-Cheol, Y1 - 2003/09/12/ PY - 2003/01/24/received PY - 2003/08/17/accepted PY - 2003/9/19/pubmed PY - 2005/7/6/medline PY - 2003/9/19/entrez SP - 9 EP - 14 JF - Rheumatology international JO - Rheumatol Int VL - 25 IS - 1 N2 - The objective was to assess the cost-effectiveness of nonsteroidal anti-inflammatory agents (NSAIDs), NSAIDs with concomitant therapy to prevent gastrointestinal (GI) toxicity, and cyclooxygenase-2 specific inhibitors (COX-2) in the treatment of rheumatoid arthritis (RA). Markov (state-transition) models were used to simulate a cohort taking disease-modifying antirheumatic drugs, low dose steroid, and one of the following strategies: (1) NSAIDs without prophylaxis, (2) NSAIDs with misoprostol, (3) NSAIDs with proton-pump inhibitor (PPI), or (4) COX-2. Costs were measured in 1999 US dollars and health effects are expressed as quality-adjusted life years (QALYs). COX-2 was the most cost-effective strategy for preventing GI toxicity. The incremental cost/effectiveness (C/E) ratio between COX-2 and no prophylaxis was 56,751 dollar/QALY. Although COX-2 are the best option (among the strategies analyzed) to prevent GI toxicity, the incremental C/E ratio between COX-2 and no prophylaxis is higher than 50,000 dollar/QALY. SN - 0172-8172 UR - https://www.unboundmedicine.com/medline/citation/13680139/Cost_effectiveness_analysis_of_NSAIDs_NSAIDs_with_concomitant_therapy_to_prevent_gastrointestinal_toxicity_and_COX_2_specific_inhibitors_in_the_treatment_of_rheumatoid_arthritis_ L2 - https://dx.doi.org/10.1007/s00296-003-0392-2 DB - PRIME DP - Unbound Medicine ER -