Summary
Nonsteroidal anti-inflammatory drugs (NSAIDs) vary in their potential to produce gastropathy. We compared the 3-month direct medical costs, including those associated with treating NSAID-induced adverse events, of nabumetone, ibuprofen, or ibuprofen plus misoprostol in 171 elderly patients with osteoarthritis.
Total direct medical costs per patient treated were $US183 for nabumetone, $US252 for ibuprofen, and $US270 for ibuprofen plus misoprostol. Differences resulted from higher costs associated with treatment of drug-related adverse events with ibuprofen, and higher drug acquisition prices with the combination regimen.
Sensitivity analyses demonstrated that direct costs with nabumetone approached those for the other 2 regimens if the price of nabumetone increased by 60%. the probabiliry of lesion formation with nabumetone increased 4-fold, the probability of a lesion >105cm being symptomatic and needing treatment was 31% or the price of misoprostol decreased by 50%.
Although this study found more lesions because of mandated endoscopies than might be recognised or treated in clinical practice, the results suggest an economic benefit of nabumetone.
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Bentkover, J.D., Baker, A.M. & Kaplan, H. Nabumetone in Elderly Patients with Osteoarthritis. Pharmacoeconomics 5, 335–342 (1994). https://doi.org/10.2165/00019053-199405040-00007
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DOI: https://doi.org/10.2165/00019053-199405040-00007