title: The cost-effectiveness of celecoxib vs diclofenac in the treatment of osteoarthritis in the UK; an update to the NICE model using data from the CONDOR trial.
abstract: OBJECTIVE
  The National Institute for Health and Clinical Excellence (NICE) health economic model for assessing the cost-effectiveness of celecoxib plus a proton pump inhibitor (PPI) compared to diclofenac plus PPI in the treatment of osteoarthritis has been updated using new adverse event (AE) risks from the CONDOR trial. In light of this new information, this study aimed to evaluate the incremental cost-effectiveness ratio (ICER) of celecoxib plus PPI compared to diclofenac plus PPI.
  
  
  METHODS
  NICE developed a health economic model as part of their 2008 multiple technology assessment of treatments for osteoarthritis. The model was adapted for this study to update the relative risks of adverse events, using data from the CONDOR trial.
  
  
  RESULTS
  Using the AE data from the CLASS trial alone, celecoxib plus PPI has an ICER of £9538 per QALY when compared to diclofenac plus PPI. When the AE data from CONDOR alone is used, this ICER decreases to £4773 per QALY. Using the pooled data from both trials, celecoxib plus PPI has an ICER of £9377 per QALY compared to diclofenac plus PPI.
  
  
  CONCLUSIONS
  The results suggest that when new AE risks are used, celecoxib plus PPI remains a cost-effective treatment for OA when compared to diclofenac plus PPI. However, this analysis is limited by the short time horizon, and additional AEs that have not been considered.
authors.affiliation: BresMed Health Solutions, Sheffield, UK. nbrereton@bresmed.co.uk
authors.forename: N
authors.initials: N
authors.lastname: Brereton
authors.forename: B
authors.initials: B
authors.lastname: Winn
authors.forename: R
authors.initials: R
authors.lastname: Akehurst
mesh_terms: D026683:Advisory Committees; D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal; D000068579:Celecoxib; D003362:Cost-Benefit Analysis; D052246:Cyclooxygenase 2 Inhibitors / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use; D004008:Diclofenac / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use; D006801:Humans; D008875:Middle Aged; D018803:Models, Economic; D010003:Osteoarthritis / Q000188:drug therapy*; D011720:Pyrazoles / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use; D016032:Randomized Controlled Trials as Topic; D013449:Sulfonamides / Q000009:adverse effects / Q000191:economics* / Q000627:therapeutic use; D006113:United Kingdom
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D011720:Pyrazoles; D013449:Sulfonamides; D004008:Diclofenac; D000068579:Celecoxib