PMID- 18194404
OWN - NLM
STAT- MEDLINE
DCOM- 20090722
LR  - 20151119
IS  - 1524-4733 (Electronic)
IS  - 1098-3015 (Linking)
VI  - 11
IP  - 4
DP  - 2008 Jul-Aug
TI  - Costs and effects of various analgesic treatments for patients with rheumatoid 
      arthritis and osteoarthritis in the Netherlands.
PG  - 589-99
LID - 10.1111/j.1524-4733.2007.00303.x [doi]
AB  - OBJECTIVE: To assess the balance between costs and upper gastrointestinal (GI) 
      side effects of treatment with celecoxib, nonsteroidal antiinflammatory drugs 
      (NSAIDs) alone, NSAID plus misoprostol, NSAID plus histamine-2 receptor 
      antagonist (H(2)RA), NSAID plus proton pump inhibitor (PPI), and Arthrotec in The 
      Netherlands. METHODS: A model was used to convene data from various sources on 
      the probability of GI side effects and resource use. The probabilities of GI side 
      effects for celecoxib and NSAIDs alone were derived from trial data. Calculations 
      were based on 6 months of treatment, and were from a societal perspective. 
      Distinction was made between low-, medium-, and high-risk patients. An extensive 
      probabilistic sensitivity analysis was performed to address uncertainty. RESULTS: 
      Assuming an average patient, the total costs per 6 months of therapy were: 
      celecoxib 255 Euro, NSAIDs alone 166 Euro, NSAID plus misoprostol 285 Euro, NSAID 
      plus H(2)RA 284 Euro, NSAID plus PPI 243 Euro, and Arthrotec 187 Euro. Treatment 
      with celecoxib was associated with the lowest number of GI side effects and 
      related deaths. Incremental costs per life-year saved for Arthrotec compared to 
      NSAIDs alone were 5676 Euro for all patients and 526 Euro for medium-to-high-risk 
      patients, whereas for high-risk patients, Arthrotec dominated NSAID alone. For 
      celecoxib compared to Arthrotec, the incremental cost-effectiveness ratios 
      (ICERs) were 56,667 Euro, 33,684 Euro, and 15,429 Euro, respectively. CONCLUSION: 
      Assuming a limit of 20,000 Euro per life-year gained, from an economic point of 
      view, Arthrotec is the preferred treatment when all patients or 
      medium-to-high-risk patients are considered. In high-risk patients, celecoxib is 
      the preferred treatment strategy.
FAU - Al, Maiwenn J
AU  - Al MJ
AD  - Institute for Medical Technology Assessment, Erasmus MC, Rotterdam, The 
      Netherlands. m.al@erasmusmc.nl
FAU - Maniadakis, Nikos
AU  - Maniadakis N
FAU - Grijseels, Els W M
AU  - Grijseels EW
FAU - Janssen, Matthijs
AU  - Janssen M
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20080108
PL  - United States
TA  - Value Health
JT  - Value in health : the journal of the International Society for Pharmacoeconomics 
      and Outcomes Research
JID - 100883818
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Arthrotec)
RN  - 0 (Drug Combinations)
RN  - 0 (Histamine H2 Antagonists)
RN  - 0 (Proton Pump Inhibitors)
RN  - 0 (Pyrazoles)
RN  - 0 (Sulfonamides)
RN  - 0E43V0BB57 (Misoprostol)
RN  - 144O8QL0L1 (Diclofenac)
RN  - JCX84Q7J1L (Celecoxib)
SB  - IM
MH  - Anti-Inflammatory Agents, Non-Steroidal/adverse effects/*economics/therapeutic 
      use
MH  - Arthritis, Rheumatoid/*drug therapy/*economics
MH  - Celecoxib
MH  - Clinical Trials as Topic
MH  - Cost-Benefit Analysis
MH  - Decision Trees
MH  - Diclofenac/adverse effects/*economics/therapeutic use
MH  - Drug Combinations
MH  - Drug Therapy, Combination
MH  - Female
MH  - Histamine H2 Antagonists/adverse effects/*economics/therapeutic use
MH  - Humans
MH  - Male
MH  - Misoprostol/adverse effects/*economics/therapeutic use
MH  - *Models, Economic
MH  - Netherlands
MH  - Osteoarthritis/*drug therapy/*economics
MH  - Proton Pump Inhibitors/adverse effects/*economics/therapeutic use
MH  - Pyrazoles/adverse effects/*economics/therapeutic use
MH  - Sulfonamides/adverse effects/*economics/therapeutic use
MH  - Treatment Outcome
EDAT- 2008/01/16 09:00
MHDA- 2009/07/23 09:00
CRDT- 2008/01/16 09:00
PHST- 2008/01/16 09:00 [pubmed]
PHST- 2009/07/23 09:00 [medline]
PHST- 2008/01/16 09:00 [entrez]
AID - S1098-3015(10)60536-0 [pii]
AID - 10.1111/j.1524-4733.2007.00303.x [doi]
PST - ppublish
SO  - Value Health. 2008 Jul-Aug;11(4):589-99. doi: 10.1111/j.1524-4733.2007.00303.x. 
      Epub 2008 Jan 8.