Pharmacoutilization and costs of osteoarthritis: changes induced by the introduction of a cyclooxygenase-2 inhibitor into clinical practice.
OBJECTIVE
To establish whether the introduction of a cyclooxygenase-2 inhibitor has led to changes in pharmacoutilization in the treatment of osteoarthritis (OA) in clinical practice.


METHODS
Administrative and general practice databases were cross-linked to analyse the use of non-steroidal anti-inflammatory drugs (NSAIDs) and gastroprotective agents (GPAs) before and after the introduction of rofecoxib. Costs of treatment and costs of hospitalization for gastrointestinal events were also considered.


RESULTS
A total of 3090 patients were evaluated. A significant reduction in the use of GPAs in the rofecoxib group was observed, corresponding to reductions of 64 and 59.7% compared to NSAIDs among patients in incident and prevalent cases respectively. The weighted mean daily cost of therapy with rofecoxib in incident cases was 1.88 euro, 7.4% lower than that of NSAIDs (2.03), and in prevalent cases it was 1.87 euro, 28.1% higher than that of NSAIDs (1.46). Although the rate of hospitalization was similar, there was an additional daily cost per patient of 186.6 for patients being treated with NSAIDs and 21.6 euro for those being treated with rofecoxib.


CONCLUSIONS
The cyclooxygenase-2 inhibitor rofecoxib determined substantial changes in the pharmacoutilization and costs of OA.
Department of Human Physiology and Pharmacology, University of Rome La Sapienza, Italy. pierluigi.russo@uniroma1.it
P
P
Russo
A
A
Capone
E
E
Attanasio
G
G
Baio
M
M
Di Martino
L
L
Degli Esposti
F
F
Marchetta
S
S
Buda
E
E
Degli Esposti
L
L
Caprino
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000191:economics / Q000627:therapeutic use; D016861:Cyclooxygenase Inhibitors / Q000191:economics* / Q000627:therapeutic use*; D016208:Databases, Factual; D016527:Drug Costs; D005260:Female; D006760:Hospitalization / Q000191:economics; D006801:Humans; D007558:Italy; D007783:Lactones / Q000191:economics* / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010003:Osteoarthritis / Q000188:drug therapy* / Q000191:economics*; D010818:Practice Patterns, Physicians' / Q000191:economics; D013222:State Medicine / Q000191:economics; D013450:Sulfones
D000894:Anti-Inflammatory Agents, Non-Steroidal; D016861:Cyclooxygenase Inhibitors; D007783:Lactones; D013450:Sulfones; C116926:rofecoxib