An Economic Model for Determining the Costs and Consequences of Using Various Treatment Alternatives for the Management of Arthritis in Canada

摘要: Objective:To construct a decision analytical model to compare the costs and clinical consequences of treating patients with celecoxib or various nonsteroidal anti-inflammatory drug (NSAID)/gastrointestinal (GI) co-therapy regimens for management osteoarthritis rheumatoid arthritis. The quantified number expected experience any GI complication commonly associated NSAID therapy. Design: Resource use treatment each in was estimated after consulting Canadian experts. Standard unit from Ontario were applied resources calculate cost complication. Main outcome measures results: revealed that NSAID-alone regimen lowest [$262 dollars ($Can) per patient 6 months] followed by ($Can273), diclofenac/misoprostol ($Can365), + histamine H2 receptor antagonist ($Can413), misoprostol ($Can421), proton pump inhibitor ($Can731). A break-even analysis showed up 80% study cohort could be treated instead without increasing health system’s overall budget. Celecoxib fewest GI-related deaths, hospitalised events, symptomatic ulcers, cases anaemia. also upper distress. Sensitivity analyses most sensitive distribution risk population ingredient alternatives. Conclusions: This indicates lead avoidance significant NSAID-attributable adverse incremental using arthritis ≥65 years age place current alternativeswould not impose an excessive impact on provincial healthcare