Abstract:
INTRODUCTION:The objective of this study was to evaluate the potential economic implications of using etoricoxib versus non-selective NSAID alternatives in the treatment of patients with osteoarthritis (OA) or rheumatoid arthritis (RA) in the UK. STUDY DESIGN:Decision-analytical modelling was used to calculate the expected costs and consequences of the use of etoricoxib compared with non-selective NSAIDs alone, NSAIDs plus proton pump inhibitors (PPIs), NSAIDs plus histamine H2 receptor antagonists and NSAIDs plus misoprostol over a continuous treatment period of 1 year. METHODS:The model considered direct medical costs from the perspective of the UK National Health Service (NHS) and used data from phase IIb and III clinical trials of etoricoxib to determine probabilities of gastrointestinal (GI) events. Model outcomes were defined as resource-consuming GI-related events, including clinically evident gastroduodenal perforations, symptomatic gastroduodenal ulcers, or upper GI bleeding (collectively, PUBs ['perforation, ulcers and/or bleeding']). Resource utilisation and costs (2002 values) for the treatment of OA and RA as well as GI events were based on published literature and information available from UK-specific sources. MAIN OUTCOME MEASURES AND RESULTS:The model suggests that etoricoxib is cost saving compared with non-selective NSAIDs plus PPIs or non-selective NSAIDs plus misoprostol. The model also suggests that etoricoxib is cost effective in terms of the incremental cost per QALY gained for non-selective NSAIDs alone (pound 19,766) and for non-selective NSAIDs plus H2 antagonists (pound 9350). The incremental cost of etoricoxib per PUB avoided was pound 12,446 versus non-selective NSAIDs alone and pound 6438 versus NSAIDs co-prescribed with H2 antagonists. For patients without the presence of specific GI risk factors (history of GI event, corticosteroid use or disability), etoricoxib may be cost effective for patients over age 56 years, assuming a cost-effectiveness threshold of pound 30,000 per QALY gained. Etoricoxib may also be cost effective in patients of all ages who had at least one specific GI risk factor. CONCLUSIONS:The model suggests, with its underlying assumptions and data, that etoricoxib is a cost-effective alternative to therapeutic regimens involving non-selective NSAIDs for OA or RA, from the UK NHS perspective. Etoricoxib may be cost saving and dominant over non-selective NSAIDs used together with a PPI or misoprostol. When compared with non-selective NSAIDs alone or non-selective NSAIDs co-prescribed with H2 antagonists, the incremental cost per QALY gained with use of etoricoxib was within the generally accepted threshold for cost effectiveness (less than pound 30,000 per QALY gained).
journal_name
Pharmacoeconomicsjournal_title
PharmacoEconomicsauthors
Moore A,Phillips C,Hunsche E,Pellissier J,Crespi Sdoi
10.2165/00019053-200422100-00003subject
Has Abstractpub_date
2004-01-01 00:00:00pages
643-60issue
10eissn
1170-7690issn
1179-2027pii
22103journal_volume
22pub_type
杂志文章abstract:OBJECTIVE:The study objective was to evaluate and compare quality-of-life (QOL) parameters between patients with type 2 (non-insulin-dependent) diabetes mellitus who changed therapy from an oral hypoglycaemic agent (OHA) to insulin and those who remained on an OHA. DESIGN:The World Health Organization Quality of Life ...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199814020-00008
更新日期:1998-08-01 00:00:00
abstract::Drug utilisation in term and preterm neonates (i.e. less than 28 days of age) has been investigated prospectively in 4 clinical studies during the past 10 years. 3880 neonates with a mean gestational age of 34.5 weeks (corresponding birthweight 2280g) were enrolled in these studies. An overview indicates a high prev...
journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
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journal_title:PharmacoEconomics
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journal_title:PharmacoEconomics
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doi:10.1007/s40273-014-0211-5
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journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
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journal_title:PharmacoEconomics
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doi:10.1007/s40273-017-0541-1
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abstract::Decision makers increasingly request evidence on the real-world cost effectiveness of a new treatment. There is, however, a lack of practical guidance on how to conduct an economic evaluation based on registry data and how this evidence can be used in actual decision making. This paper explains the required steps on h...
journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.1007/s40273-015-0260-4
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journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-199813020-00007
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journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
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更新日期:2017-12-01 00:00:00
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journal_title:PharmacoEconomics
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journal_title:PharmacoEconomics
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doi:10.1007/s40273-015-0312-9
更新日期:2015-10-01 00:00:00
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更新日期:2020-06-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
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更新日期:2020-04-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 杂志文章
doi:10.2165/00019053-200725080-00006
更新日期:2007-01-01 00:00:00
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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
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journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章,随机对照试验
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journal_title:PharmacoEconomics
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更新日期:1994-08-01 00:00:00
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更新日期:2002-01-01 00:00:00
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pub_type: 杂志文章,评审
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更新日期:2015-03-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 杂志文章,评审
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更新日期:2001-01-01 00:00:00
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更新日期:2006-01-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 已发布勘误
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更新日期:2019-02-01 00:00:00
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journal_title:PharmacoEconomics
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journal_title:PharmacoEconomics
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更新日期:1996-02-01 00:00:00
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journal_title:PharmacoEconomics
pub_type: 临床试验,杂志文章
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