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Rheumatology Advance Access originally published online on March 31, 2003
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Rheumatology 2003; 42: 879-887
© 2003 British Society for Rheumatology

Pharmacoutilization and costs of osteoarthritis: changes induced by the introduction of a cyclooxygenase-2 inhibitor into clinical practice

P. Russo, A. Capone2, E. Attanasio1, G. Baio3, M. Di Martino4, L. Degli Esposti4, F. Marchetta5, S. Buda4, E. Degli Esposti6 and L. Caprino1

Department of Human Physiology and Pharmacology and
1 Department of Experimental Medicine and Pathology, University of Rome ‘La Sapienza’,
2 Outcomes Research Engineering Consulting, Rome,
3 EPRIS Research Group, University of Siena, Siena,
4 Clicon S.r.l., Health, Economics, and Outcome Research, Ravenna,
5 Sant'Orsola Malpighi Hospital, Bologna and
6 Local Health Unit 110, Ravenna, Italy

Objective. To establish whether the introduction of a cyclooxygenase-2 inhibitor has led to changes in pharmacoutilization in the treatment of osteoarthritis (OA) in clinical practice.

Methods. Administrative and general practice databases were cross-linked to analyse the use of non-steroidal anti-inflammatory drugs (NSAIDs) and gastroprotective agents (GPAs) before and after the introduction of rofecoxib. Costs of treatment and costs of hospitalization for gastrointestinal events were also considered.

Results. A total of 3090 patients were evaluated. A significant reduction in the use of GPAs in the rofecoxib group was observed, corresponding to reductions of 64 and 59.7% compared to NSAIDs among patients in incident and prevalent cases respectively. The weighted mean daily cost of therapy with rofecoxib in incident cases was \#8364;1.88, 7.4% lower than that of NSAIDs (\#8364;2.03), and in prevalent cases it was \#8364;1.87, 28.1% higher than that of NSAIDs (\#8364;1.46). Although the rate of hospitalization was similar, there was an additional daily cost per patient of \#8364;186.6 for patients being treated with NSAIDs and \#8364;21.6 for those being treated with rofecoxib.

Conclusions. The cyclooxygenase-2 inhibitor rofecoxib determined substantial changes in the pharmacoutilization and costs of OA.

KEY WORDS: Osteoarthritis, NSAIDs, COX-2-specific inhibitors, Clinical practice, Costs.

Correspondence to: P. Russo, Institute of Pharmacology (Department of Human Physiology and Pharmacology), University of Rome ‘La Sapienza’, P. le A. Moro, 5-00185, Italy. E-mail: pierluigi.russo{at}uniroma1.it


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