تقرير
Cost effectiveness of COX 2 selective inhibitors and traditional NSAIDs alone or in combination with a proton pump inhibitor for people with osteoarthritis
| العنوان: | Cost effectiveness of COX 2 selective inhibitors and traditional NSAIDs alone or in combination with a proton pump inhibitor for people with osteoarthritis |
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| المؤلفون: | Latimer, N, Lord, J, Grant, RL, O'Mahony, R, Dickson, J, Conaghan, PG, Natl Inst Hlth, Clinical Excellence Osteoarthrit G |
| بيانات النشر: | BMJ publishing group |
| سنة النشر: | 2009 |
| المجموعة: | Brunel University London: Brunel University Research Archive (BURA) |
| مصطلحات موضوعية: | Nonsteroidal antiinflammatory drugs, Randomized controlled-trial, Therapeutic arthristic reseach, Placebo-controlled trial, Cyclo-oxygenase-2 inhibitors, Rheumatoid-arthristis, Gastrointestinal toxicity, Economic-evaluation, Risk, Outcomes |
| الوصف: | This is an open access article - Copyright @ 2009 BMJ publishing group ; OBJECTIVES: To investigate the cost effectiveness of cyclo-oxygenase-2 (COX 2) selective inhibitors and traditional non-steroidal anti-inflammatory drugs (NSAIDs), and the addition of proton pump inhibitors to these treatments, for people with osteoarthritis. DESIGN: An economic evaluation using a Markov model and data from a systematic review was conducted. Estimates of cardiovascular and gastrointestinal adverse events were based on data from three large randomised controlled trials, and observational data were used for sensitivity analyses. Efficacy benefits from treatment were estimated from a meta-analysis of trials reporting total Western Ontario and McMaster Universities (WOMAC) osteoarthritis index score. Other model inputs were obtained from the relevant literature. The model was run for a hypothetical population of people with osteoarthritis. Subgroup analyses were conducted for people at high risk of gastrointestinal or cardiovascular adverse events. COMPARATORS: Licensed COX 2 selective inhibitors (celecoxib and etoricoxib) and traditional NSAIDs (diclofenac, ibuprofen, and naproxen) for which suitable data were available were compared. Paracetamol was also included, as was the possibility of adding a proton pump inhibitor (omeprazole) to each treatment. MAIN OUTCOME MEASURES: The main outcome measure was cost effectiveness, which was based on quality adjusted life years gained. Quality adjusted life year scores were calculated from pooled estimates of efficacy and major adverse events (that is, dyspepsia; symptomatic ulcer; complicated gastrointestinal perforation, ulcer, or bleed; myocardial infarction; stroke; and heart failure). RESULTS: Addition of a proton pump inhibitor to both COX 2 selective inhibitors and traditional NSAIDs was highly cost effective for all patient groups considered (incremental cost effectiveness ratio less than £1000 (€1175, $1650)). This finding was robust across a wide range of effectiveness ... |
| نوع الوثيقة: | report |
| اللغة: | English |
| تدمد: | 0959-8146 |
| العلاقة: | 2438/10287; http://bura.brunel.ac.uk/handle/2438/10287Test; BMJ 339: b2538, Jul 2009; http://bura.brunel.ac.uk/handle/2438/6033Test; http://dx.doi.org/10.1136/bmj.b2538Test |
| DOI: | 10.1136/bmj.b2538 |
| الإتاحة: | https://doi.org/10.1136/bmj.b2538Test http://bura.brunel.ac.uk/handle/2438/6033Test |
| رقم الانضمام: | edsbas.BB6888A0 |
| قاعدة البيانات: | BASE |
| تدمد: | 09598146 |
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| DOI: | 10.1136/bmj.b2538 |