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- arthritis (rheumatoid)
- peptic ulcer
- cyclo-oxygenase inhibitors
- anti-inflammatory agents (non-steroidal)
QUESTION: In patients with osteoarthritis or rheumatoid arthritis, does the reduction in gastrointestinal (GI) complications seen with coxibs offset their increased cost compared with non-steroidal anti-inflammatory drugs (NSAIDs)?
Cost utility analysis using a decision analytic model from the perspective of a third party payer considering direct medical costs.
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.
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 …
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