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Efficiency of naproxen/esomeprazole in association for osteoarthrosis treatment in Spain.
Reumatol Clin. 2014 Jul-Aug; 10(4):210-7.RC

Abstract

OBJECTIVE

To assess, from the perspective of the National Healthcare System, the efficiency of a fixed-dose combination of naproxen and esomeprazole (naproxen/esomeprazole) in the treatment of osteoarthritis (OA) compared to other NSAID, alone or in combination with a proton pump inhibitor (PPI).

METHODS

A Markov model was used; it included different health states defined by gastrointestinal (GI) events: dyspepsia, symptomatic or complicated ulcer; or cardiovascular (CV) events: myocardial infarction, stroke or heart failure. The model is similar to the one used by NICE in its NSAID evaluation of OA published in 2008. The total costs (€, 2012), including drug and event-related costs, and the health outcomes expressed in quality-adjusted life years (QALY) were estimated in patients with increased GI risk, aged 65 or over, for a 1-year time horizon and a 6-month treatment with celecoxib (200mg/day), celecoxib+PPI, diclofenac (150mg/day)+PPI, etoricoxib (60mg/day), etoricoxib+PPI, ibuprofen (1,800mg/day)+PPI, naproxen (1,000mg/day)+PPI or naproxen/esomeprazole (naproxen 1,000mg/esomeprazole 40mg/day). The selected PPI was omeprazole (20mg/day).

RESULTS

Naproxen/esomeprazole was a dominant strategy (more effective and less costly) compared to celecoxib, etoricoxib and diclofenac+PPI. Celecoxib+PPI and etoricoxib+PPI were more effective. Considering a cost-effectiveness threshold of €30,000 per additional QALY, naproxen/esomeprazole was cost-effective compared to ibuprofen+PPI and naproxen+PPI with incremental cost-effectiveness ratios (ICER) of €15,154 and €5,202 per additional QALY, respectively.

CONCLUSIONS

A fixed-dose combination of naproxen and esomeprazole is a cost-effective, and even dominant, alternative compared to other options in OA patients with increased GI risk.

Authors+Show Affiliations

Health Economics & Outcomes Research, AstraZeneca Farmacéutica Spain, Madrid, España.Servicio de Reumatología, Hospital General Universitario de Guadalajara, Guadalajara, España.Servicio de Cardiología, Hospital Ramón y Cajal, Madrid, España.Pharmacoeconomics and Outcomes Research Iberia, Madrid, España. Electronic address: ioyaguez@porib.com.Pharmacoeconomics and Outcomes Research Iberia, Madrid, España.Health Economics & Outcomes Research, AstraZeneca Farmacéutica Spain, Madrid, España.Servicio de Aparato Digestivo, Hospital Clínico, CIBERehd, IIS Aragón, Universidad de Zaragoza, Zaragoza, España.

Pub Type(s)

Clinical Study
Comparative Study
Journal Article

Language

eng spa

PubMed ID

24380809

Citation

Capel, Margarita, et al. "Efficiency of Naproxen/esomeprazole in Association for Osteoarthrosis Treatment in Spain." Reumatologia Clinica, vol. 10, no. 4, 2014, pp. 210-7.
Capel M, Tornero J, Zamorano JL, et al. Efficiency of naproxen/esomeprazole in association for osteoarthrosis treatment in Spain. Reumatol Clin. 2014;10(4):210-7.
Capel, M., Tornero, J., Zamorano, J. L., Oyagüez, I., Casado, M. Á., Sánchez-Covisa, J., & Lanas, A. (2014). Efficiency of naproxen/esomeprazole in association for osteoarthrosis treatment in Spain. Reumatologia Clinica, 10(4), 210-7. https://doi.org/10.1016/j.reuma.2013.11.009
Capel M, et al. Efficiency of Naproxen/esomeprazole in Association for Osteoarthrosis Treatment in Spain. Reumatol Clin. 2014 Jul-Aug;10(4):210-7. PubMed PMID: 24380809.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Efficiency of naproxen/esomeprazole in association for osteoarthrosis treatment in Spain. AU - Capel,Margarita, AU - Tornero,Jesús, AU - Zamorano,José Luis, AU - Oyagüez,Itziar, AU - Casado,Miguel Ángel, AU - Sánchez-Covisa,Joaquín, AU - Lanas,Angel, Y1 - 2013/12/29/ PY - 2013/06/18/received PY - 2013/10/21/revised PY - 2013/11/20/accepted PY - 2014/1/2/entrez PY - 2014/1/2/pubmed PY - 2016/4/5/medline KW - Antiinflamatorios no esteroideos KW - Artrosis KW - Cost-utility KW - Coste-utilidad KW - Nonsteroidal anti-inflammatory drugs KW - Osteoarthrosis SP - 210 EP - 7 JF - Reumatologia clinica JO - Reumatol Clin VL - 10 IS - 4 N2 - OBJECTIVE: To assess, from the perspective of the National Healthcare System, the efficiency of a fixed-dose combination of naproxen and esomeprazole (naproxen/esomeprazole) in the treatment of osteoarthritis (OA) compared to other NSAID, alone or in combination with a proton pump inhibitor (PPI). METHODS: A Markov model was used; it included different health states defined by gastrointestinal (GI) events: dyspepsia, symptomatic or complicated ulcer; or cardiovascular (CV) events: myocardial infarction, stroke or heart failure. The model is similar to the one used by NICE in its NSAID evaluation of OA published in 2008. The total costs (€, 2012), including drug and event-related costs, and the health outcomes expressed in quality-adjusted life years (QALY) were estimated in patients with increased GI risk, aged 65 or over, for a 1-year time horizon and a 6-month treatment with celecoxib (200mg/day), celecoxib+PPI, diclofenac (150mg/day)+PPI, etoricoxib (60mg/day), etoricoxib+PPI, ibuprofen (1,800mg/day)+PPI, naproxen (1,000mg/day)+PPI or naproxen/esomeprazole (naproxen 1,000mg/esomeprazole 40mg/day). The selected PPI was omeprazole (20mg/day). RESULTS: Naproxen/esomeprazole was a dominant strategy (more effective and less costly) compared to celecoxib, etoricoxib and diclofenac+PPI. Celecoxib+PPI and etoricoxib+PPI were more effective. Considering a cost-effectiveness threshold of €30,000 per additional QALY, naproxen/esomeprazole was cost-effective compared to ibuprofen+PPI and naproxen+PPI with incremental cost-effectiveness ratios (ICER) of €15,154 and €5,202 per additional QALY, respectively. CONCLUSIONS: A fixed-dose combination of naproxen and esomeprazole is a cost-effective, and even dominant, alternative compared to other options in OA patients with increased GI risk. SN - 1885-1398 UR - https://www.unboundmedicine.com/medline/citation/24380809/Efficiency_of_naproxen/esomeprazole_in_association_for_osteoarthrosis_treatment_in_Spain_ L2 - http://www.elsevier.es/en/linksolver/pdf/pii/S1699-258X(13)00225-8 DB - PRIME DP - Unbound Medicine ER -