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Coxibs were not cost effective for arthritis pain in patients with average risk of ulcer complications

Key Words: arthritis (rheumatoid) • osteoarthritis • peptic ulcer • cyclo-oxygenase inhibitors • anti-inflammatory agents (non-steroidal)

The first 150 words of the full text of this article appear below.

Design
Cost utility analysis using a decision analytic model from the perspective of a third party payer considering direct medical costs.

Setting
USA.

Patients
A hypothetical cohort of patients 60 years of age with osteoarthritis or rheumatoid arthritis who were not taking aspirin and required NSAID therapy for moderate to severe arthritis pain.

Intervention
Patients who entered the model were treated with a coxib (celecoxib, 200 mg once daily, or rofecoxib, 25 mg once daily) or a non-selective NSAID at the maximum dose approved by the US Food and Drug Administration (naproxen, 500 mg twice daily). The model was designed to test the hypothesis that coxibs are cost effective alternatives to NSAIDs.

Main cost and outcome measures
A decision tree was constructed to represent the coxib and naproxen strategies. Clinical probability estimates were derived from a systematic review of the literature using Medline and hand searching 2 subspecialty journals (January 1985 to December 2002). Validated utilities were assigned for . . . [Full text of this article]

Loren Laine, MD

University of Southern California
Los Angeles, California, USA