The economic consequences of NSAID-induced gastropathy: the French context.
The costs of treating gastroduodenal ulcers caused by nonsteroidal anti-inflammatory drugs (NSAIDs) are shown to increase the total cost of NSAID treatment to the Assurance-Maladie, the French national health insurance system. This increased cost is termed the iatrogenic cost factor, and is defined as the ratio of the shadow price of an NSAID to its reimbursed cost. The shadow price is calculated from estimates of the incidence of NSAID-induced gastropathies, the cost of the drug, and the hospital and ambulatory costs of treating the gastropathies. The resulting iatrogenic cost factors are estimated as 1.36 for naproxen, 1.48 for sulindac, 1.65 for diclofenac, 1.67 for piroxicam, 2.00 for ketoprofen, and 2.12 for etodolac.
de Pouvourville
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Centre de Recherche en Gestion, Ecole Polytechnique, Paris, France.
D000553:Ambulatory Care / Q000191:economics; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000191:economics / Q000627:therapeutic use; D017281:Cost of Illness; D004008:Diclofenac / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D004381:Duodenal Ulcer / Q000139:chemically induced / Q000191:economics / Q000453:epidemiology; D004469:Economics, Hospital; D017308:Etodolac / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D005602:France / Q000453:epidemiology; D005767:Gastrointestinal Diseases / Q000139:chemically induced* / Q000191:economics* / Q000453:epidemiology; D006801:Humans; D007660:Ketoprofen / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D009288:Naproxen / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D009313:National Health Programs / Q000191:economics; D010894:Piroxicam / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use; D012216:Rheumatic Diseases / Q000188:drug therapy / Q000453:epidemiology; D013467:Sulindac / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use
D000894:Anti-Inflammatory Agents, Non-Steroidal; D010894:Piroxicam; D004008:Diclofenac; D013467:Sulindac; D017308:Etodolac; D009288:Naproxen; D007660:Ketoprofen