Healthy Skepticism Library item: 10255

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Publication type: Journal Article

Ariza Ariza R.
How to avoid the gastrointestinal pain in the treatment of arthrosis. Cost-benefit approximation of the different alternatives in the Spanish market
Seminarios de la Fundacion Espanola de Reumatologia 2003; 4:(3):93-103

Abstract:

Non steroidal antiinflammatory drugs (NSAIDs) are used as treatment of the osteoarthritis. They have high gastrointestinal toxicity. Gastrointestinal drugs (proton pump inhibitors, H2 antagonists or misoprostol) or selective inhibitors of cyclooxygenase 2 (COX-2) can be used in order to prevents the NSAID’s induced gastrointestinal adverse events. However, the prices of COX-2 selective inhibitors are higher than those of the non selective NSAIDs. So, an economic evaluation of these strategies is required. In this work, the main characteristics of the pharmacoeconomics studies are reviewed. The main determinants of the results of the economic evaluations of the COX-2 selective inhibitors vs nonselective NSAIDs in the treatment of the osteoarthritis are analyzed. The pharmacoeconomics studies about this topic in Spain are discussed. The conclusions are that the main factor conditioning the results of this economic evaluation are the prices of nonselective NSAIDs and gastrointestinal drugs, the frequency of the prescriptions of gastrointestinal drugs and the gastrointestinal risk of the target population. The COX-2 selective inhibitors are a dominant option in scenarios with target population with high gastrointestinal risk, with frequent use of gastrointestinal drugs and choosing the most expensive nonselective NSAIDs and gastrointestinal drugs.