Pharmacoeconomic aspects of non-steroidal anti-inflammatory drug gastropathy.
Non-steroidal anti-inflammatory drugs are commonly used to reduce inflammation and pain associated with arthritis. However, non-steroidal anti-inflammatory drugs induce gastrointestinal side-effects such as dyspeptic symptoms, duodenal or gastric ulcers and, in some cases, serious complications. The aim has been to compare the benefits with the drawbacks of non-steroidal anti-inflammatory drug treatment using a hypothetical population representing patients with arthritis. A problem description was made on the basis of a literature review, and a simple and hypothetical health economic model was constructed. Including direct and indirect costs, the annual total costs in Sweden for gastrointestinal side-effects per non-steroidal anti-inflammatory drug user were estimated to be 3,420 SEK (438 US$), and the approximated costs of arthritis were 60,000 SEK (7,692 US$). The benefits of non-steroidal anti-inflammatory drug treatment were found to outweigh the drawbacks if the patient's arthritis symptoms, expressed as a difference in utility value between having and not having symptoms of arthritis, are improved by 6% or more. Costs for non-steroidal anti-inflammatory drug-induced gastrointestinal side-effects should be evaluated in relation to the benefits of non-steroidal anti-inflammatory drugs in the treatment of inflammation and pain. A simple modelling approach indicated that treatment with non-steroidal anti-inflammatory drugs may be highly cost-effective as both the clinical and economic benefits for patients responding to such treatment out-weighed possible drawbacks.
Walan
A
A
Astra Hässle AB, Mölndal, Sweden.
Wahlqvist
P
P
D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use; D001172:Arthritis, Rheumatoid / Q000188:drug therapy / Q000191:economics*; D003362:Cost-Benefit Analysis; D016527:Drug Costs / Q000592:standards* / Q000639:trends; D004381:Duodenal Ulcer / Q000139:chemically induced / Q000191:economics*; D004415:Dyspepsia / Q000139:chemically induced / Q000191:economics*; D017850:Economics, Pharmaceutical; D017048:Health Care Costs; D006801:Humans; D018803:Models, Economic; D011336:Probability; D019057:Quality-Adjusted Life Years; D013276:Stomach Ulcer / Q000139:chemically induced / Q000191:economics* / Q000453:epidemiology; D013548:Sweden
D000894:Anti-Inflammatory Agents, Non-Steroidal