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Rheumatology Advance Access published online on March 31, 2003
Rheumatology, doi:10.1093/rheumatology/keg242
Rheumatology © British Society for Rheumatology 2003; all rights reserved
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© 2003 British Society for Rheumatology

Original Papers

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

P. Russo 1*, A. Capone 2, E. Attanasio 3, G. Baio 4, M. Di Martino 5, L. Degli Esposti 5, F. Marchetta 6, S. Buda 5, E. Degli Esposti 7, L. Caprino 3

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

* Corresponding author. E-mail: pierluigi.russo{at}uniroma1.it.

Received 2 August 2002 ; accepted 11 December 2002

Abstract

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 Euro 1.88, 7.4% lower than that of NSAIDs (Euro 2.03), and in prevalent cases it was Euro 1.87, 28.1% higher than that of NSAIDs (Euro 1.46). Although the rate of hospitalization was similar, there was an additional daily cost per patient of Euro 186.6 for patients being treated with NSAIDs and Euro 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.
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