Pharmacoeconomics of NSAIDs: Beyond Bleeds

OBJECTIVE: To determine the marginal effect of including a minor, yet common, gastrointestinal (GI) side effect in a cost effectiveness analysis of NSAID therapy. DESIGN: Base economic model of cost effectiveness analysis (CEA) developed using data from a randomized controlled trial of two formulations of an NSAID therapy (conventional versus extended release etodolac) for the treatment of osteoarthritis (OA) of the knee. SETTING: Outpatient. PARTICIPANTS: 225 patients with osteoarthritis of the knee. INTERVENTIONS: Patients were randomized to receive either conventional or extended release etodolac with primary endpoints evaluated at four weeks. Cost effectiveness was calculated from a managed care perspective as dollars spent per OA patient treated, focusing on the marginal dollar value of reduced side effects. Costs included in the analysis were initial ($64 or $71) and subsequent ($64) prescriptions for NSAID therapy, pharmacological treatment of side effects ($79) and physician office visits ($50). M...