PMID- 21370937
OWN - NLM
STAT- MEDLINE
DCOM- 20110728
LR  - 20131121
IS  - 1473-4877 (Electronic)
IS  - 0300-7995 (Linking)
VI  - 27
IP  - 5
DP  - 2011 May
TI  - A new perspective on the pharmacoeconomics of colchicine.
PG  - 931-7
LID - 10.1185/03007995.2011.563284 [doi]
AB  - BACKGROUND: Gout is a common inflammatory arthritis that affects  approximately 4% of the US 
      population. Most patients with gout are >50 years of age and have multiple 
      comorbidities. Gout is caused by the deposition of monosodium urate crystals in 
      joints secondary to hyperuricemia. Gout typically presents as an acute painful 
      inflammation (flare) involving one or more joint. Left untreated it can progress 
      into a more chronic polyarthritis. Acute gout flare treatment options include 
      colchicine, non-steroidal anti-inflammatory drugs (NSAIDs), and corticosteroids. 
      The safety and efficacy of colchicine, especially in the presence of comorbidity 
      and potential contraindications, has only recently been systematically 
      investigated. METHODS: Through the use of a systematic computer-based literature 
      analysis, this pharmacoeconomic review evaluated costs, risks, and benefits of 
      Colcrys (colchicine) compared with other treatments for gout in the US. RESULTS: 
      Both colchicine and NSAIDs are historically associated with gastrointestinal (GI) 
      adverse events (AEs). Colchicine has very low risk for AEs, even in patients with 
      GI disorders; whereas, NSAIDS are contraindicated in patients with GI disorders, 
      renal insufficiency, and heart failure. The monthly cost of treating 100 patients 
      with Colcrys was $33,100 compared with $3000 for NSAIDs. However, hospitalization 
      for GI complications (1.8%) and heart failure (1.9%) is common with NSAIDs and 
      can increase the monthly cost of treating 100 patients with NSAIDs to $161,000, 
      considering $15,000-20,000 per day of hospitalization. CONCLUSIONS: Considering 
      high costs associated with treating patients with gout, it seems prudent to 
      choose the treatment with greatest benefit, lowest cost, and least risk. Despite 
      higher cost per dose, colchicine appears to be more cost effective for management 
      of gout flares than NSAIDs.
FAU - Wertheimer, Albert I
AU  - Wertheimer AI
AD  - Temple University School of Pharmacy, Philadelphia, PA 19140, USA. 
      albertw@temple.edu
FAU - Davis, Matthew W
AU  - Davis MW
FAU - Lauterio, Thomas J
AU  - Lauterio TJ
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
PT  - Review
DEP - 20110303
PL  - England
TA  - Curr Med Res Opin
JT  - Current medical research and opinion
JID - 0351014
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Gout Suppressants)
RN  - 268B43MJ25 (Uric Acid)
RN  - SML2Y3J35T (Colchicine)
SB  - IM
MH  - Aged
MH  - Anti-Inflammatory Agents, Non-Steroidal/economics/therapeutic use
MH  - Arthritis/drug therapy/economics/etiology/mortality
MH  - Chronic Disease
MH  - Colchicine/*economics/therapeutic use
MH  - Costs and Cost Analysis
MH  - Female
MH  - Gout/complications/drug therapy/*economics/metabolism/mortality
MH  - Gout Suppressants/*economics/therapeutic use
MH  - Humans
MH  - Hyperuricemia/drug therapy/economics/etiology/mortality
MH  - Male
MH  - Middle Aged
MH  - United States/epidemiology
MH  - Uric Acid/metabolism
EDAT- 2011/03/05 06:00
MHDA- 2011/07/29 06:00
CRDT- 2011/03/05 06:00
PHST- 2011/03/05 06:00 [entrez]
PHST- 2011/03/05 06:00 [pubmed]
PHST- 2011/07/29 06:00 [medline]
AID - 10.1185/03007995.2011.563284 [doi]
PST - ppublish
SO  - Curr Med Res Opin. 2011 May;27(5):931-7. doi: 10.1185/03007995.2011.563284. Epub 
      2011 Mar 3.