title: [Cost-effectiveness analysis of celecoxib versus non-selective non-steroidal anti-inflammatory drug therapy for the treatment of osteoarthritis in Spain: A current perspective].
abstract: OBJECTIVE
  To assess the cost-effectiveness of celecoxib and non-selective non-steroidal anti-inflammatory drugs for the treatment of osteoarthritis in clinical practice in Spain.
  
  
  METHODS
  A decision-tree model using distribution, doses, treatment duration and incidence of GI and CV events observed in the pragmatic PROBE-designed «GI-Reasons» trial was used for cost-effectiveness. Effectiveness was expressed in terms of event averted and quality-adjusted life-years (QALY) gained. QALY were calculated based on utility decrement in case of any adverse events reported in GI-Reasons trial. The National Health System perspective in Spain was applied; cost calculations included current prices of drugs plus cost of adverse events occurred. The analysis was expressed as an incremental cost-effectiveness ratio per QALY gained and per event averted. One-way and probabilistic analyses were performed.
  
  
  RESULTS
  Compared with non-selective non-steroidal anti-inflammatory drugs, at current prices, celecoxib treatment had higher overall treatment costs €201 and €157, respectively. However, celecoxib was associated with a slight increase in QALY gain and significantly lower incidence of gastrointestinal events (p<.001), with mean incremental cost-effectiveness ratio of €13,286 per QALY gained and €4,471 per event averted. Sensitivity analyses were robust, and confirmed the results of the base case.
  
  
  CONCLUSIONS
  Celecoxib at current price may be considered as a cost-effective alternative vs. non-selective non-steroidal anti-inflammatory drugs in the treatment of osteoarthritis in daily practice in the Spanish NHS.
authors.affiliation: Máster en Evaluación Sanitaria y Acceso al Mercado (Farmacoeconomía), Universidad Carlos III, Getafe, Madrid, España.
authors.forename: A
authors.initials: A
authors.lastname: De Lossada
authors.affiliation: Servicio de Cirugía Ortopédica y Traumatología, Hospital General Universitario Gregorio Marañón, Madrid, España.
authors.forename: Á
authors.initials: Á
authors.lastname: Oteo-Álvaro
authors.affiliation: UGC Limonar , Málaga, España.
authors.forename: S
authors.initials: S
authors.lastname: Giménez
authors.affiliation: Pharmacoeconomics & Outcomes Research Iberia, Pozuelo de Alarcón, Madrid, España.
authors.forename: I
authors.initials: I
authors.lastname: Oyagüez
authors.affiliation: Departamento de Farmacoeconomía e Investigación de Resultados en Salud, Pfizer SLU, Alcobendas, Madrid, España. Electronic address: javier.rejas@pfizer.com.
authors.forename: J
authors.initials: J
authors.lastname: Rejas
mesh_terms: D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D002318:Cardiovascular Diseases / Q000191:economics / Q000453:epidemiology; D000068579:Celecoxib / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D003362:Cost-Benefit Analysis; D052246:Cyclooxygenase 2 Inhibitors / Q000009:adverse effects / Q000191:economics / Q000627:therapeutic use*; D003663:Decision Trees; D016527:Drug Costs; D005767:Gastrointestinal Diseases / Q000191:economics / Q000453:epidemiology; D006801:Humans; D015994:Incidence; D009313:National Health Programs / Q000191:economics; D010003:Osteoarthritis / Q000188:drug therapy* / Q000191:economics; D019057:Quality-Adjusted Life Years; D012189:Retrospective Studies; D013030:Spain
chemical_list: D000894:Anti-Inflammatory Agents, Non-Steroidal; D052246:Cyclooxygenase 2 Inhibitors; D000068579:Celecoxib
keywords: Antiinflamatorio no esteroideo; Artrosis; Celecoxib; Cost-effectiveness; Coste-efectividad; Daily practice; National Health System; Non-selective non-steroidal anti-inflammatory drug; Osteoarthritis; Práctica clínica; Sistema Nacional de Salud