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Titolo:
Economic evaluation of rofecoxib versus nonselective nonsteroidal anti-inflammatory drugs for the treatment of osteoarthritis
Autore:
Pellissier, JM; Straus, WL; Watson, DJ; Kong, SX; Harper, SE;
Indirizzi:
Merck Res Labs, Clin & Hlth Econ Stat, Blue Bell, PA 19422 USA Merck Res Labs Blue Bell PA USA 19422 Econ Stat, Blue Bell, PA 19422 USA Merck & Co Inc, US Human Hlth, Outcomes Res & Management, W Point, PA USA Merck & Co Inc W Point PA USA Outcomes Res & Management, W Point, PA USA Merck & Co Inc, Worldwide Outcomes Res, Whitehouse Stn, NJ USA Merck & Co Inc Whitehouse Stn NJ USA utcomes Res, Whitehouse Stn, NJ USA
Titolo Testata:
CLINICAL THERAPEUTICS
fascicolo: 7, volume: 23, anno: 2001,
pagine: 1061 - 1079
SICI:
0149-2918(200107)23:7<1061:EEORVN>2.0.ZU;2-S
Fonte:
ISI
Lingua:
ENG
Soggetto:
PLACEBO-CONTROLLED TRIAL; QUALITY-OF-LIFE; ANTIINFLAMMATORY DRUGS; GASTROINTESTINAL COMPLICATIONS; RHEUMATOID-ARTHRITIS; GASTRIC-ULCER; DOUBLE-BLIND; MEDICAL-MANAGEMENT; COST-EFFECTIVENESS; RANDOMIZED TRIAL;
Keywords:
rofecoxib; nonsteroidal anti-inflammatory drugs; costs; decision analysis;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Clinical Medicine
Citazioni:
67
Recensione:
Indirizzi per estratti:
Indirizzo: Pellissier, JM Merck Res Labs, Clin & Hlth Econ Stat, 10 Sentry Pkwy, BlueBell, PA 19422USA Merck Res Labs 10 Sentry Pkwy Blue Bell PA USA 19422 422USA
Citazione:
J.M. Pellissier et al., "Economic evaluation of rofecoxib versus nonselective nonsteroidal anti-inflammatory drugs for the treatment of osteoarthritis", CLIN THER, 23(7), 2001, pp. 1061-1079

Abstract

Background. Results of phase III clinical trials of rofecoxib, a selectiveinhibitor of cyclooxygenase 2, have shown that osteoarthritis patients treated with rofecoxib had Significantly fewer clinically significant gastrointestinal (GI) adverse events than those who received nonselective nonsteroidal anti-inflammatory drugs (NSAIDs). Objective: This paper explores the potential economic implications of the use of rofecoxib versus nonselective NSAIDs for the treatment of osteoarthritis via a decision analytic model based on rofecoxib clinical data and thepublished literature. Methods: Base-case 1-year analyses were done with data on GI adverse events, specifically perforations, ulcers, and bleeds (PUBs), obtained from a prespecified pooled analysis of the rofecoxib clinical trials, Analyses were also performed using pooled results of two 12-week endoscopic surveillance trials, with adjustments for silent ulcers of 40% and 85%. Results: Under base-case conditions, the expected cost savings in GI problems and comedications averted with rofecoxib versus NSAIDs was $0.81 per day, representing an 85% offset of the difference in drug price. For rofecoxib versus NSAIDs, the expected cost per PUB avoided with rofecoxib was $4738, and expected cost per year of life saved was $18,614. In analyses based on endoscopic data, therapy with rofecoxib was less expensive than therapy with NSAIDs, regardless of silent ulcer adjustment. Results weremost sensitive to prophylactic GI comedication rates, and were robust over a range of model assumptions and costs. Conclusions: In this analysis based on differences in clinically significant GI events for osteoarthritis patients, cost differences between rofecoxib and NSAIDs were markedly offset by expected cost savings in GI problems and comedications averted with rofecoxib. Costs per year of life saved with rofecoxib versus NSAIDs were well within accepted benchmarks for cost-effectiveness. When endoscopic data alone were considered, rofecoxib was cost saving across all assumptions about silent ulcer rates.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 09/07/20 alle ore 20:57:49