[Cost-effectiveness analysis of the use of celecoxib for the treatment of osteoarthritis].
BACKGROUND
Non-steroidal anti-inflammatory drugs (NSAIDs), used for the treatment of osteoarthritis, can produce serious gastrointestinal (GI) adverse reactions.Celecoxib, a specific COX-2 inhibitor, has a proven efficacy equivalent to that of traditional NSAIDs with an improved tolerance and safety profile.


OBJECTIVE
The objective of this study was to perform a cost-effectiveness analysis on the use of celecoxib versus traditional NSAIDs in the treatment of osteoarthritis.


METHODS
This cost-effectiveness analysis was designed through a pharmacoeconomic model; each effectiveness unit was defined as each year of life gained after the ingestion of celecoxib or NSAIDs. The probability of different clinical results appearing was obtained from published articles and incorporated assumptions. Only direct medical costs were evaluated (medication, hospitalization, additional tests, analyses, extra visits, etc.) and other costs were excluded. The study perspective was the national health system and the time horizon chosen was 6 months.


RESULTS
The additional cost for each year of life gained through the use of celecoxib compared with that of traditional NSAIDs amounted to 8017; (1,333,834 ptas). Sensitivity analysis demonstrated how these values were sensitive to changes in the costs of NSAIDs and gastroprotective agents as well as to the inclusion of younger population groups.


CONCLUSIONS
Celecoxib can be considered as a cost-effective option in the treatment of osteoarthritis because its use prevents deaths and increases survival rate and the additional cost is reasonable and moderate compared with that of NSAIDs. Its efficiency increases in proportion to its use in younger patients and probably in those at high risk for developing GI complications.
Moreno
A
A
Servicio de Farmacología Clínica. Hospital Clínico San Carlos. Madrid. España.
Vargas
E
E
Soto
J
J
Rejas
J
J
D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000191:economics* / Q000627:therapeutic use*; D000068579:Celecoxib; D003362:Cost-Benefit Analysis; D003663:Decision Trees; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000188:drug therapy*; D011720:Pyrazoles; D012680:Sensitivity and Specificity; D013449:Sulfonamides / Q000191:economics* / Q000627:therapeutic use*
D000894:Anti-Inflammatory Agents, Non-Steroidal; D011720:Pyrazoles; D013449:Sulfonamides; D000068579:Celecoxib