Abstract:
OBJECTIVE:To assess the economic efficiency of meloxicam, a cyclo-oxygenase (COX)-2 selective inhibitor, versus diclofenac and piroxicam in the UK for the treatment of patients with osteoarthritis and the impact on the NHS budget of substituting nonselective NSAIDs with meloxicam. Methods and perspective: A decision analytical model was used to compare the effects of 4 weeks' treatment of osteoarthritis with meloxicam (7.5 mg/day), diclofenac (100 mg/day) and piroxicam (20 mg/day). The decision tree was derived by combining best practice and clinical reality. Analysis was from the NHS perspective. The study considered only the direct costs. These included costs for drug acquisition and management of all adverse events, both serious gastrointestinal events requiring hospitalisation, and non-serious events that required maintenance. Resource use and treatment costs were obtained from local and published sources. A range of sensitivity analyses was carried out. RESULTS:Based on two 4-week large-scale trials, the Meloxicam Large-scale International Study Safety Assessment (MELISSA) and Safety and Efficacy Large-scale Evaluation of COX-inhibiting Therapies (SELECT) trials, and a decision analytical model, the findings suggested that meloxicam had the lowest cost per patient ( pound 30 versus pound 35 for piroxicam and pound 51 for diclofenac [costs presented as 1998 values except for drug costs which were in 2000 values]). The results of the Monte Carlo probabilistic sensitivity analysis, using 4000 samples, suggested that meloxicam was the optimal strategy in the drug treatment of patients with osteoarthritis compared with nonselective NSAIDs both individually and as a group. The cost savings were due to lower levels of serious adverse events accompanied by fewer days in intensive care units and shorter overall duration of hospital stay observed with meloxicam compared with diclofenac and piroxicam in the 4-week trials. CONCLUSIONS:Based on the 4-week trial period, meloxicam was predicted to be the lowest cost drug therapy, and thus the optimal drug therapy, in the management of patients with osteoarthritis compared with nonselective NSAIDs such as diclofenac and piroxicam. Applying the cost savings per patient derived from the model, switching patients from piroxicam and diclofenac to meloxicam would indicate a cost saving of over pound 25 million per annum. Models such as this can facilitate better clinical guidance and is a useful way of assessing treatment outcomes.
journal_name
Pharmacoeconomicsjournal_title
PharmacoEconomicsauthors
Tavakoli Mdoi
10.2165/00019053-200321060-00007subject
Has Abstractpub_date
2003-01-01 00:00:00pages
443-54issue
6eissn
1170-7690issn
1179-2027pii
2167journal_volume
21pub_type
杂志文章abstract::Peptic ulcer disease (PUD) is a common medical problem costing billions of dollars annually around the world. Since the availability of the first histamine H2-receptor antagonist, cimetidine, many economic analyses have been conducted to compare the impact of this drug class on resource consumption. H2-Antagonists h...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-199405040-00006
更新日期:1994-04-01 00:00:00
abstract:BACKGROUND:A wide variety of oral antiplatelet trials have been carried out, and a large number of cost-effectiveness estimates based on them have been published. OBJECTIVE:To assess the cost effectiveness of oral antiplatelet treatments in the prevention of cardiovascular events. METHODS:A comprehensive literature s...
journal_title:PharmacoEconomics
pub_type: 杂志文章,meta分析,评审
doi:10.2165/00019053-200725120-00007
更新日期:2007-01-01 00:00:00
abstract::Scientific reviewing methods were applied to economic studies of influenza vaccination, and an economic model of influenza vaccination was developed from these primary sources. Issues arising from the secondary literature review include the quality of evidence on the effectiveness of the vaccines, the absence of a tra...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199600093-00015
更新日期:1996-01-01 00:00:00
abstract::Recent studies have shown that ACE inhibitors reduce morbidity and mortality after myocardial infarction (MI). While these trials have obvious clinical implications, the widespread introduction of a new treatment for a condition as common as MI also has clear cost implications. The results of the post-MI studies with ...
journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章
doi:10.2165/00019053-199712020-00008
更新日期:1997-08-01 00:00:00
abstract::About one-quarter of men aged 50 years and older experience voiding problems due to benign prostatic hyperplasia (BPH). Until about 10 years ago, surgery (particularly transurethral resection of the prostate) was the only effective treatment for symptomatic BPH. Over the last decade, several new treatments have been i...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200119020-00003
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND AND OBJECTIVE:Intensive insulin therapy improves glycosylated haemoglobin (Hb(A1C)) levels and delays the onset of long-term diabetes-related complications. Current treatment guidelines recommend maintaining a glycosylated haemoglobin (Hb(A1C)) of < or = 7% in patients with type 1 and 2 diabetes mellitus. Ho...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200725030-00007
更新日期:2007-01-01 00:00:00
abstract::The role of economic evaluation in the efficient allocation of healthcare resources has been widely debated. Whilst economic evidence is undoubtedly useful to purchasers, it does not address the issue of affordability which is an increasing concern. Healthcare purchasers are concerned not just with maximising efficien...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200119060-00001
更新日期:2001-01-01 00:00:00
abstract:BACKGROUND:Combination therapies with cetuximab (Erbitux®; Merck Serono UK Ltd) and panitumumab (Vectibix®; Amgen UK Ltd) are shown to be less effective in adults with metastatic colorectal cancer who have mutations in exons 2, 3 and 4 of KRAS and NRAS oncogenes from the rat sarcoma (RAS) family. OBJECTIVE:The objecti...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-018-0630-9
更新日期:2018-07-01 00:00:00
abstract::Due to a single error in the annual cost of sarilumab the following needs to be corrected in the article. ...
journal_title:PharmacoEconomics
pub_type: 已发布勘误
doi:10.1007/s40273-019-00857-7
更新日期:2020-01-01 00:00:00
abstract::Most countries have healthcare resource constraints and it is easy to identify new health technologies as an area in need of resource management, particularly given that new health technologies usually increase rather than save costs. Resource constraints are even more noticeable in Asia than in other regions, with a ...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/11310280-000000000-00000
更新日期:2009-01-01 00:00:00
abstract::Multiple sclerosis (MS) is a disease of the CNS, typically striking adults during the primary productive time of their life. The symptoms of MS can restrict the individual's physical activity and income-earning ability, resulting in a major financial burden on the patient, family, health system and society. This syste...
journal_title:PharmacoEconomics
pub_type: 杂志文章,meta分析,评审
doi:10.2165/11532230-000000000-00000
更新日期:2010-01-01 00:00:00
abstract::Rufinamide (Inovelon®), a triazole derivative, is an oral antiepileptic drug approved in the EU as adjunctive therapy in the treatment of seizures associated with Lennox-Gastaut syndrome (LGS) in patients aged ≥4 years. The efficacy of oral rufinamide as adjunctive therapy in patients with LGS uncontrolled on one to t...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/11208630-000000000-00000
更新日期:2012-03-01 00:00:00
abstract::This century has seen a phenomenal growth in the development, understanding and use of pharmaceuticals. Additionally, this period has seen the balance of the treatment needs of patients shift dramatically from infectious to cardiovascular and cancer diseases, and from infancy and middle-age to old age. The value of mo...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199813060-00001
更新日期:1998-06-01 00:00:00
abstract::The purpose of this study was to estimate the direct and indirect costs of alcoholism in the Federal Republic of Germany. Direct costs comprised treatment costs, while indirect costs consisted mainly of costs incurred as a result of work time lost, as well as costs related to premature retirement and premature mortali...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199610050-00006
更新日期:1996-11-01 00:00:00
abstract:BACKGROUND:Like other developed countries with aging populations, Sweden is expecting large increases in the prevalence of Alzheimer's disease and corresponding escalations in the cost of care for patients with this disease. Galantamine, a new acetylcholinesterase inhibitor and nicotinic modulator, has proved effective...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200220090-00006
更新日期:2002-01-01 00:00:00
abstract::The objective of this study was to demonstrate the cost effectiveness of long term maintenance treatment with citalopram versus standard therapy (defined as short term antidepressant treatment) in patients with major depression in Germany. We chose doxepin, amitriptyline and trimipramine as standard therapy because th...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199508020-00007
更新日期:1995-08-01 00:00:00
abstract::In a recent leading article in PharmacoEconomics, Nuijten described some methods for incorporating uncertainty into health economic models and for utilising the information on uncertainty regarding the cost effectiveness of a therapy in resource allocation decision-making. His proposals are found to suffer from seriou...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200523060-00001
更新日期:2005-01-01 00:00:00
abstract::Total hip arthroplasty (THA) is a major orthopaedic procedure with a high risk of postoperative thromboembolism. Increasing demand for this type of surgery, together with its high cost, has led to examination of means by which the cost of THA may be minimised. Current clinical opinion favours the use of suitable pharm...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199610020-00009
更新日期:1996-08-01 00:00:00
abstract:OBJECTIVE:To estimate savings in the cost of caring for patients with Alzheimer's disease (AD) during 6 months, 1 year and 2 years of treatment with rivastigmine. An intermediate objective was to estimate the relationship between disease progression and institutionalisation. DESIGN AND SETTING:We assessed the relation...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200017040-00005
更新日期:2000-04-01 00:00:00
abstract:OBJECTIVE:The objective of this study was to estimate the per-patient-per-month (PPPM) costs of medications in the six Medicare Part D protected classes based on findings among Medicare and dual eligible beneficiaries with drug coverage before the enactment of the benefit. DESIGN:Data were from the Thomson Medstat Mar...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200624003-00007
更新日期:2006-01-01 00:00:00
abstract::Deterministic sensitivity analyses (DSA) remain important to interpret the effect of uncertainties in individual parameters on results of cost-effectiveness analyses. Classic DSA methodologies may lead to wrong conclusions due to a lack of or misleading information regarding marginal effects, non-linearity, likelihood...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-020-00979-3
更新日期:2021-01-01 00:00:00
abstract:OBJECTIVE:To examine the relative cost effectiveness of topical calcipotriol and short-contact dithranol in the treatment of mild to moderate plaque psoriasis. DESIGN AND SETTING:This was a modelling study from the perspective of the UK National Health Service as payer. METHODS:The interventions were compared using 2...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200018050-00006
更新日期:2000-11-01 00:00:00
abstract::Productivity costs are frequently omitted from economic evaluations, despite their often strong impact on cost-effectiveness outcomes. This neglect may be partly explained by the lack of standardization regarding the methodology of estimating productivity costs. This paper aims to contribute to standardization of prod...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-014-0132-3
更新日期:2014-04-01 00:00:00
abstract::Answering the demanding questions asked of pharmacotherapy in the 21st century will require more reliance on the disciplines of pharmacoepidemiology and pharmacoeconomics. Pharmacoepidemiology can help assess patterns and appropriateness of drug utilisation, provide explanations for poor compliance, quantify the frequ...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/00019053-200422002-00009
更新日期:2004-01-01 00:00:00
abstract::A survey of the prescribing of psychotropic drugs was carried out at the Psychiatric Hospital of Bahrain. This retrospective study on 60 inpatients of the Long Stay Ward revealed a man:woman ratio of 2.7. 91% of the men and 88% of the women were over 40 years old. 44 of the 60 patients had a diagnosis of schizophre...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199201030-00007
更新日期:1992-03-01 00:00:00
abstract:BACKGROUND:Assessment of health state and health-related quality of life (HR-QOL) are limited by a child's age and cognitive ability. Parent-proxy reports are known to differ from children's reports. Simultaneous assessment using a parent-child dyad is an alternative approach. OBJECTIVE:Our objective was to assess the...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/11597890-000000000-00000
更新日期:2012-08-01 00:00:00
abstract:OBJECTIVE:The reliability and validity of generic utility measures have not yet been summarized in people with multiple sclerosis (MS). It is important to assess the psychometric properties of these measures, to ensure that the values obtained by the scoring system are valid for interpretation and utilization by clinic...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.1007/s40273-014-0167-5
更新日期:2014-08-01 00:00:00
abstract:OBJECTIVE:To determine whether the use of risperidone in a US managed-care environment is associated with a reduction in the use of mental healthcare services. METHODS:Mental health service use and costs for patients with psychoses treated with risperidone versus those treated with conventional antipsychotic agents we...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200220060-00006
更新日期:2002-01-01 00:00:00
abstract::External genital warts (EGW) are a sexually transmitted infection caused by various strains of human papillomavirus (HPV). Several studies have described the direct and indirect costs of EGW, while others have reported on the burden of EGW in terms of the impact on the quality of life (QOL) of patients. The arrival of...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.2165/11591170-000000000-00000
更新日期:2012-01-01 00:00:00
abstract::As part of its single technology appraisal (STA) process, the National Institute for Health and Care Excellence (NICE) invited the manufacturer (Sanofi Genzyme) of sarilumab (SAR; Kevzara®) to submit evidence of its clinical effectiveness and cost-effectiveness for previously treated moderate or severe rheumatoid arth...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
doi:10.1007/s40273-018-0677-7
更新日期:2018-12-01 00:00:00