Economic analysis are being widely used in industrialized countries to supporl the health-related decision making process. The goal being that of maximising benefits from scarce resources. Serious gastrointestinal side effects are considered as one of the major problems associated with the administration of nonsteroidal anti-inflammatory drugs (NSAlDs) in the effective treatment of arthritic diseases. Clinical trials demonstrate that Misoprostol protects the gastric and duodenal mucosa from the damage induced by NSAIDs. An economic evaluation analysis is carried out in this study to assess the costs and benefits of the treatment of osteoarthritis and rheumatoid arthritis with a fixed combination of Diclofenac and Misoprostol in comparison with the traditional NSAIDs (Diclofenac, Piroxicam or Naproxen). The fixed combination Diclofenac-Misoprostol results to be cost-saving in comparison with other NSAIDs in the treatment of osteoarthritis for 4 weeks, at a dosage regimen of two, or three times daily, and in the treatment of rheumatoid arthritis for 12-weeks at the dosage of two times daily; an extra cost resulted in a 12-week treatment of rheumatoid arthritis at three times daily posology only. Three sensitivity analysis were carried out in order to calculate the effect onfinal results of changes concerning data of hospitalization and surgery, and the incidence of silent ulcers. These analysis partly confirmed the soundness of the results obtained in the economic evaluation, and highlighted as critical variables the incidence rate of ulcers as well as the treatment daily regimen. Results have to be considered cautiously as direct costs have been assessed only and no indirect or intangible costs have been valued, which are likely to be a relevant part of the total cost of the treatment. Further research might be addressed to envisage the categories of patients who mainly benefit from the new drug as well as the identification and assessment of patients' preferences and quality of life.
Un’analisi di convenienza economica comparata: il trattamento dell’osteoartrosi e dell’artrite reumatoide con farmaci antinfiammatori non steoridei
TARRICONE, ROSANNA
1998
Abstract
Economic analysis are being widely used in industrialized countries to supporl the health-related decision making process. The goal being that of maximising benefits from scarce resources. Serious gastrointestinal side effects are considered as one of the major problems associated with the administration of nonsteroidal anti-inflammatory drugs (NSAlDs) in the effective treatment of arthritic diseases. Clinical trials demonstrate that Misoprostol protects the gastric and duodenal mucosa from the damage induced by NSAIDs. An economic evaluation analysis is carried out in this study to assess the costs and benefits of the treatment of osteoarthritis and rheumatoid arthritis with a fixed combination of Diclofenac and Misoprostol in comparison with the traditional NSAIDs (Diclofenac, Piroxicam or Naproxen). The fixed combination Diclofenac-Misoprostol results to be cost-saving in comparison with other NSAIDs in the treatment of osteoarthritis for 4 weeks, at a dosage regimen of two, or three times daily, and in the treatment of rheumatoid arthritis for 12-weeks at the dosage of two times daily; an extra cost resulted in a 12-week treatment of rheumatoid arthritis at three times daily posology only. Three sensitivity analysis were carried out in order to calculate the effect onfinal results of changes concerning data of hospitalization and surgery, and the incidence of silent ulcers. These analysis partly confirmed the soundness of the results obtained in the economic evaluation, and highlighted as critical variables the incidence rate of ulcers as well as the treatment daily regimen. Results have to be considered cautiously as direct costs have been assessed only and no indirect or intangible costs have been valued, which are likely to be a relevant part of the total cost of the treatment. Further research might be addressed to envisage the categories of patients who mainly benefit from the new drug as well as the identification and assessment of patients' preferences and quality of life.
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