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 July 21, 2003
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Cost-Effective Arthritis Treatment
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LOS ANGELES (Ivanhoe Newswire) -- Two common drugs are typically prescribed to treat arthritis pain. One can irritate the stomach and cause ulcers in some patients. While the other does not irritate the stomach, it is much more expensive. A new study examines the cost-effectiveness of these two treatments.

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen and naproxen are often prescribed for arthritis pain. While the drugs are less expensive, they can cause stomach ulcers in some patients. Cyclooxygenase-2 (COX-2) inhibitors, such as celecoxib and rofecoxib, are much more expensive drugs used to treat arthritis pain. However, most people who take these drugs never develop ulcers. The question is whether the increased cost of the latter drug is worth the potential benefits. Researchers from the Veterans Administration Greater Los Angeles Healthcare System conducted a computer-based study to determine the answer.

Instead of actual patients, researchers used computers to simulate what would happen in a group of patients with arthritis who took either NSAIDs or a COX-2 inhibitor. They estimated the cost of the drugs and how much the COX-2 inhibitor would cost for each year of life saved by avoiding a bleeding ulcer. They looked at both quality and length of life.

Researchers say COX-2 inhibitors would cost $275,809 more per year of life saved compared to treatment with NSAIDs. Authors of the study comment that this amount of money is much more than Americans are typically willing to pay for a health care treatment. However, the cost dropped to an acceptable level when the COX-2 inhibitors were only given to patients with a history of a bleeding ulcer.

Researchers conclude that unless the price of COX-2 inhibitors drops by one-tenth of their current price, the benefits of these drugs are not cost-effective for all patients with arthritis. However, researchers note the extra costs are cost- effective for arthritis patients who have had a previous bleeding ulcer.

This article was reported by Ivanhoe.com, who offers Medical Alerts by e-mail every day of the week. To subscribe, go to: http://www.ivanhoe.com/newsalert/.

SOURCE: Annals of Internal Medicine, 2003;138:795-806

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