Direct medical costs of serious gastrointestinal ulcers among users of NSAIDs.
BACKGROUND
The occurrence and prevention of gastrointestinal ulcers during use of NSAIDs has become a major healthcare issue.


OBJECTIVE
To determine the direct medical costs of serious NSAID-related ulcer complications.


METHODS
An observational cost-of-illness study was conducted in a large general hospital serving a population of 152,989 persons. From November 2001 to December 2003 all consecutive patients hospitalised with serious NSAID-related ulcer complications were identified. Serious NSAID-related ulcer complications were defined as ulcerations of the stomach or proximal duodenum causing perforation, obstruction or bleeding that occurred during the use of NSAIDs, necessitating hospitalisation of the patient. Data were retrieved with respect to days hospitalised and the number and type of diagnostic and therapeutic interventions. The main outcome measure was estimated mean direct medical costs of resources used.


RESULTS
A total of 104 patients were hospitalised with serious NSAID-related ulcer complications (incidence 31.4 per 100,000 persons per year). Most patients were elderly (mean 70.4 years, SD 16.7). In-hospital mortality was 10.6%. Mean direct medical costs were euro 8375 (95% CI 7067, 10 393). On the basis of these results, we estimated that approximately 5105 people are hospitalised with serious NSAID-related ulcer complications in The Netherlands each year, of whom 541 die in hospital. The total annual direct medical costs for serious NSAID-related ulcer complications in The Netherlands were estimated to be euro 42,754 375 (95% CI 36 077 035, 53 056 265).


CONCLUSIONS
Serious NSAID-related ulcer complications have a mortality rate of 10.6% in The Netherlands and the annual direct medical costs to the country of such complications are approximately euro 42,750 000.
Vonkeman
Harald E
HE
Department of Rheumatology and Clinical Immunology, Medisch Spectrum Twente Hospital, and University of Twente, Enschede, The Netherlands. H.Vonkeman@ziekenhuis-mst.nl
Klok
Rogier M
RM
Postma
Maarten J
MJ
Brouwers
Jacobus R B J
JR
van de Laar
Mart A F J
MA
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects* / Q000191:economics*; D004180:Direct Service Costs; D005260:Female; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010437:Peptic Ulcer / Q000139:chemically induced* / Q000191:economics* / Q000401:mortality
D000894:Anti-Inflammatory Agents, Non-Steroidal
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