PMID- 24914585
OWN - NLM
STAT- MEDLINE
DCOM- 20150514
LR  - 20151119
IS  - 1941-837X (Electronic)
IS  - 1369-6998 (Linking)
VI  - 17
IP  - 9
DP  - 2014 Sep
TI  - A cost-effectiveness analysis of celecoxib compared with diclofenac in the 
      treatment of pain in osteoarthritis (OA) within the Swedish health system using 
      an adaptation of the NICE OA model.
PG  - 677-84
LID - 10.3111/13696998.2014.933111 [doi]
AB  - OBJECTIVES: Celecoxib for the treatment of pain resulting from osteoarthritis 
      (OA) was reviewed by the Tandvards- och lakemedelsformansverket-Dental and 
      Pharmaceutical Benefits Board (TLV) in Sweden in late 2010. This study aimed to 
      evaluate the incremental cost-effectiveness ratio (ICER) of celecoxib plus a 
      proton pump inhibitor (PPI) compared to diclofenac plus a PPI in a Swedish 
      setting. METHODS: The National Institute for Health and Care Excellence (NICE) in 
      the UK developed a health economic model as part of their 2008 assessment of 
      treatments for OA. In this analysis, the model was reconstructed and adapted to a 
      Swedish perspective. Drug costs were updated using the TLV database. Adverse 
      event costs were calculated using the regional price list of Southern Sweden and 
      the standard treatment guidelines from the county council of Stockholm. Costs for 
      treating cardiovascular (CV) events were taken from the Swedish DRG codes and the 
      literature. RESULTS: Over a patient's lifetime treatment with celecoxib plus a 
      PPI was associated with a quality-adjusted life year (QALY) gain of 0.006 per 
      patient when compared to diclofenac plus a PPI. There was an increase in 
      discounted costs of 529 kr per patient, which resulted in an incremental 
      cost-effectiveness ratio (ICER) of 82,313 kr ($12,141). Sensitivity analysis 
      showed that treatment was more cost effective in patients with an increased risk 
      of bleeding or gastrointestinal (GI) complications. CONCLUSIONS: The results 
      suggest that celecoxib plus a PPI is a cost effective treatment for OA when 
      compared to diclofenac plus a PPI. Treatment is shown to be more cost effective 
      in Sweden for patients with a high risk of bleeding or GI complications. It was 
      in this population that the TLV gave a positive recommendation. There are known 
      limitations on efficacy in the original NICE model.
FAU - Brereton, Nicholas
AU  - Brereton N
AD  - BresMed , Sheffield , UK.
FAU - Pennington, Becky
AU  - Pennington B
FAU - Ekelund, Mats
AU  - Ekelund M
FAU - Akehurst, Ronald
AU  - Akehurst R
LA  - eng
PT  - Journal Article
PT  - Research Support, Non-U.S. Gov't
DEP - 20140630
PL  - England
TA  - J Med Econ
JT  - Journal of medical economics
JID - 9892255
RN  - 0 (Anti-Inflammatory Agents, Non-Steroidal)
RN  - 0 (Cyclooxygenase 2 Inhibitors)
RN  - 0 (Proton Pump Inhibitors)
RN  - 0 (Pyrazoles)
RN  - 0 (Sulfonamides)
RN  - 144O8QL0L1 (Diclofenac)
RN  - JCX84Q7J1L (Celecoxib)
SB  - IM
MH  - Anti-Inflammatory Agents, Non-Steroidal/economics/therapeutic use
MH  - Celecoxib
MH  - Cost-Benefit Analysis
MH  - Cyclooxygenase 2 Inhibitors/economics/therapeutic use
MH  - Diclofenac/administration & dosage/adverse effects/*economics/*therapeutic use
MH  - Drug Therapy, Combination
MH  - Humans
MH  - Markov Chains
MH  - Models, Economic
MH  - Osteoarthritis/*drug therapy
MH  - Proton Pump Inhibitors/administration & dosage/economics
MH  - Pyrazoles/administration & dosage/adverse effects/*economics/*therapeutic use
MH  - Quality-Adjusted Life Years
MH  - Sulfonamides/administration & dosage/adverse effects/*economics/*therapeutic use
MH  - Sweden
OTO - NOTNLM
OT  - CONDOR
OT  - Celecoxib
OT  - Cost effectiveness
OT  - Diclofenac
OT  - Incremental cost effectiveness ratio
OT  - Osteoarthritis
OT  - Quality adjusted life year
EDAT- 2014/06/11 06:00
MHDA- 2015/05/15 06:00
CRDT- 2014/06/11 06:00
PHST- 2014/06/11 06:00 [entrez]
PHST- 2014/06/11 06:00 [pubmed]
PHST- 2015/05/15 06:00 [medline]
AID - 10.3111/13696998.2014.933111 [doi]
PST - ppublish
SO  - J Med Econ. 2014 Sep;17(9):677-84. doi: 10.3111/13696998.2014.933111. Epub 2014 
      Jun 30.