title: Budget impact modeling for a single-tablet formulation of ibuprofen and famotidine for prevention of upper gastrointestinal ulcers in patients with osteoarthritis and/or rheumatoid arthritis.
abstract: BACKGROUND
  Single-tablet ibuprofen/famotidine is approved by the US Food and Drug Administration for the relief of signs and symptoms of rheumatoid arthritis and osteoarthritis and to decrease the risk of developing upper gastrointestinal (GI) ulcers in patients taking ibuprofen for those indications. Currently, little is known about the cost impact of gastroprotective therapies, and an estimate of the financial consequences of adopting these therapies will be helpful to decision makers.
  
  
  OBJECTIVE
  The goal of this study was to review a model that evaluates the expected financial impact to US health care plans from the introduction of single-tablet ibuprofen/famotidine into the chronic NSAID user population.
  
  
  METHODS
  A budget impact model, considering a typical health plan of 1 million enrollees, was used to compare patients receiving: (1) single-tablet ibuprofen/famotidine; (2) chronic NSAID treatment plus any GI-protective agent; and (3) chronic NSAID treatment without a GI-protective agent.
  
  
  RESULTS
  The expected medication cost for single-tablet ibuprofen/famotidine was $734,192 ($81,577 in year 1, $244,731 in year 2, and $407,884 in year 3), corresponding to a total per-member per-month cost of $0.020 ($0.007 in year 1, $0.020 in year 2, and $0.034 in year 3). Considering anticipated decreases in the use of other NSAIDs, the use of GI-protective agents, and GI complications, the total expected 3-year drug cost for single-tablet ibuprofen/famotidine was offset by 50%, representing an estimated total budget impact of $364,396 or $0.010 per member per month. Sensitivity analyses of cost and market share variables and clinical and drug characteristics identified the most influential variables to be the cost of the drug and persistence to the ibuprofen/famotidine formulation, respectively.
  
  
  CONCLUSIONS
  The expected decrease in treatment costs for less serious GI-related complications illustrates the benefits of single-tablet ibuprofen/famotidine as a gastroprotective therapy in patients receiving chronic NSAID treatment, with a modest financial impact on total health care costs.
authors.affiliation: PriceSpective LLC, Los Angeles, CA, USA.
authors.forename: Renee
authors.initials: R
authors.lastname: Kuan
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Holt
authors.forename: Kenneth E
authors.initials: KE
authors.lastname: Johnson
authors.forename: Jeffrey D
authors.initials: JD
authors.lastname: Kent
authors.forename: David A
authors.initials: DA
authors.lastname: Peura
authors.forename: Dan
authors.initials: D
authors.lastname: Malone
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage / Q000191:economics / Q000627:therapeutic use; D000897:Anti-Ulcer Agents / Q000008:administration & dosage* / Q000191:economics; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D004338:Drug Combinations; D016527:Drug Costs; D015738:Famotidine / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D006801:Humans; D007052:Ibuprofen / Q000008:administration & dosage* / Q000191:economics / Q000627:therapeutic use; D018803:Models, Economic; D010003:Osteoarthritis / Q000150:complications / Q000188:drug therapy*; D010349:Patient Compliance; D013276:Stomach Ulcer / Q000150:complications / Q000517:prevention & control*; D013607:Tablets
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D000897:Anti-Ulcer Agents; D004338:Drug Combinations; D013607:Tablets; D015738:Famotidine; D007052:Ibuprofen